job satisfaction among healthcare professionals in area
TRANSCRIPT
Job Satisfaction among Healthcare Professionals in
Area Military Health Unit KwaZulu-Natal
by
Veni Govender
Supervisor: Dr Karen Ortlepp
Submitted in partial fulfilment of the requirements for the degree of
Masters of Business Administration
University of KwaZulu-Natal
October 2006
EXECUTIVE SUMMARY
The current legislation in South Africa, namely the White Paper on Transformation of the
Public Sector published on the 15 November 1995 by the Department of Public Service
and Administration, addresses the need for transformation in the delivery of Public
Services. The aim of this transformation process is to improve the efficiency and
effectiveness of the way in which public services should be rendered, with the emphasis
on customer focused ways of working.
The South African Military Health Services (SAMHS) as a public service healthcare
organisation within the South African Department of Defence (SANDF) is also governed
by the White Paper on transformation, and is constantly reminded of the call for
improved service delivery to its clientele.
According to Schenke (2001:8) it is critical to understand that an interdependent
relationship exists between employee satisfaction and customer satisfection, and therefore
an organisation would need to focus on both these assets.
An integral part of optimising service delivery in the SAMHS and improving customer
satisfection, would be to ensure job satisfection among the healthcare professionals who
render the services. Spytak, Marsland and Ulmer (1999:26) noted that satisfied
employees tend to be more productive, creative and committed to their jobs.
A study was therefore undertaken to review job satisfection among health care
professionals in a sample population in the SAMHS. The study examined the main
contributing factors that affected job satisfection, and determined if there were
differences in terms of job satisfection across the demographic variables of age, gender,
marital status, employees with or without children and tenure. Finally it explored the
correlation between job satisfection levels and intention to leave. The study constituted a
comparative cross-sectional study of 61 healthcare professionals based at Area Military
Health Unit KwaZulu Natal (AMHU KZN).
i
/
The research methodology adopted in this study was a quantitative survey. Statistical
analyses were completed using ANOVA'S, Pearson's Correlations and Factor Analysis.
The results of the study indicated that there were four major contributing factors affecting
job satisfection and these included, career management, strategic management and
support, the nature of the work itself and interpersonal dynamics.
There were no differences noted in job satisfection across the demographic variables of
age, gender, marital status, employees with or without children and tenure. However
results did indicate that there was a strong correlation between total job satisfaction and
propensity to leave. A strong correlation was also found with each of the four main
components affecting job satisfection, namely career management, strategic management
and support, the nature of the work itself, interpersonal dynamics, and propensity to
leave.
Recommendations were made to the SAMHS with regard to job enrichment,
compensation systems, staffing and promotions, and management style. The
implementation of these recommendations could assist in improving the levels of job
satisfection among health care professionals. The study also recommended further
research to better understand issues that could impact on job satisfection of health care
professionals in the military environment.
11
DECLARATION
I, Veni Govender, hereby declare that the contents of this dissertation is my own work,
and that all sources utilised have been accurately reported and acknowledged, and that
this dissertation has not been submitted at any university in order to obtain an academic
qualification.
Signed:..&^V£*?V."t. on this -?-?of October 2006.
m
ACKNOWLEDGEMENTS
I thank God for guiding me every step of the way and giving me the strength to face the
challenges I had to endure in completing my studies.
I would also like to thank the following people:
• To all the health care professionals who took the time to participate in this survey
and the managers of the Health Service Centres, who assisted in administering the
survey.
• My husband Vanil for his love and support and most importantly for taking care
of our sons, Svanik and Ishalin.
• My parents and my sisters for their support, their words of wisdom and advice.
• My mum you deserve special thanks, you have been my inspiration and the
driving force behind everything that I have accomplished.
• My supervisor Dr Karen Ortlepp, for your expert guidance and supervision. I was
truly blessed to have you as a supervisor. Your calm, caring and positive
approach gave me the strength to see this dissertation through.
• Lt Col A. Van Breda for taking the time to provide me with advice and guidance.
• My uncle Vasu for his ongoing morale support and assistance, I know you would
be proud of my achievement.
• Mr S Ramroop for assisting with the statistical analysis.
• My friend Nicki Davies for your words of encouragement and your ongoing
support.
• To MBA house staff for their support throughout my studies.
• Prof Debbie Vigar-Ellis who has always been firm but fair.
IV
CONTENTS
Executive Summary i
Declaration iii
Acknowledgements iv
Contents v
List of Tables x
List of Figures xi
List of Acronyms xi
CHAPTER 1: INTRODUCTION TO RESEARCH PROBLEM
1.1 Introduction 1
1.2 Research Purpose 3
1.3 Objectives of the Study 3
1.4 Overview of the Research Report 4
CHAPTER 2: THEORIES OF JOB SATISFACTION
2.1 Introduction 6
2.2 Concept of Job Satisfaction 6
2.3 Theories of Job Satisfaction 10
2.3.1 Content Theories 10
2.3.1.1 Maslow's Need Hierarchy Theory 10
2.3.1.2 Alderfer's Need Theory 15
2.3.1.3 Hertzberg's Two Factor Theory 17
2.3.1.4 McClelland's Need Motivation 20
2.3.2 Process Theories 23
2.3.2.1 Adam's Equity Theory 24
2.3.2.2 Reference Group Theory 26
2.3.2.3 Need/Value Fulfilment Theory 27
2.3.2.4 The Expectancy Theory 28
v
2.3.3 Conclusion 30
2.4 Demographic Differences among Individuals and Job Satisfaction 31
2.4.1 Introduction 31
2.4.2 Gender 32
2.4.3 Age 33
2.4.4 Tenure 34
2.4.5 Other Demographic Characteristics 34
2.4.6 Conclusion 35
2.5 Job Satisfaction and Turnover 35
2.5.1 Introduction 35
2.5.2 A Conceptual model of Labour Turnover 36
2.5.3 Predictors of Employee Turnover 39
2.5.4 Reducing Employee Turnover 43
2.5.5 Conclusion 45
CHAPTER 3: BACKGROUND TO THE ORGANISATION
3.1 Overview of the Department of Defence 46
3.1.1 Human Resource Strategy 2010 47
3.2 Overview of the SAMHS 47
3.2.1 Military Health Capabilities 48
3.2.2 Area Military Health Service KwaZulu-Natal 49
CHAPTER 4: RESEARCH METHODOLOGY
4.0 Introduction 51
4.1 Research Design 51
4.2 Sample 52
4.3 Research Instrument 53
4.3.1 Demographic Questionnaire 53
4.3.2 Job Satisfaction Questionnaire 53
4.3.3 Propensity to Leave Scale 57
4.4 Procedure 58
vi
4.5 Time Frame 58
4.6 Ethical Considerations 58
4.7 Assumptions 59
4.8 Data Analysis 59
CHAPTER 5: RESULTS
5. Introduction 60
5.1 Description of Sample 61
5.1.1 Gender 61
5.1.2 Age 61
5.1.3 Tenure 62
5.1.4 Marital Status 62
5.1.5 Children 63
5.2 Reliability of Measuring Instruments 63
5.3 Objective 1: To Determine the Major Contributing Factors 64
Affecting Job Satisfection.
5.3.1 Principal Component Analysis 64
5.3.2 Majority Endorsement 69
5.3.2.1 Career Management 69
5.3.2.2 Strategic Management and Support 70
5.3.2.3 Nature of Work Itself. 70
5.3.2.4 Interpersonal Dynamics 71
5.3.3 Summary 71
5.4 Objective 2: To Determine if there are Differences in Job
Satisfection across the Demographic Variables 72
5.4.1 Gender 72
5.4.2 Age 73
5.4.3 Tenure 74
5.4.4 Marital Status 75
5.4.5 Children 76
5.4.6 Summary 77
vn
5.5 Objective 3: To Explore the Correlation between Job Satisfection
and Intention to Leave 78
5.5.1 Summary 78
CHAPTER 6: DISCUSSION
6.0 Introduction 80
6.1 Demographic Distribution of Sample 80
6.1.1 Age 80
6.1.2 Gender 81
6.1.3 Tenure 81
6.1.4 Marital Status 82
6.1.5 Children 82
6.2 Major Contributing Factors Affecting Job Satisfection 83
6.2.1 Career Management. 83
6.2.2 Strategic Management and Support 87
6.2.3 Nature of Work Itself. 90
6.2.4 Interpersonal Dynamics 92
6.2.5 Summary 95
6.3 The Level of Job Satisfection across the Different Demographic
Variables 95
6.3.1 Gender 96
6.3.2 Age 97
6.3.3 Tenure 99
6.3.4 Marital Status 99
6.3.5 Children... 100
6.3.6 Summary 101
6.4 Correlation between Job Satisfection and Propensity to Leave 101
6.4.1 Career Management and Propensity to Leave 102
6.4.2 Strategic Management and Propensity to Leave 104
6.4.3 Nature of the Work Itself and Propensity to Leave 105
6.4.4 Interpersonal Dynamics and Propensity to Leave 106
Vll l
6.4.5 Summary 107
CHAPTER 7: CONCLUSIONS
7.1 Introduction 108
7.2 Demographic Profile of the Healthcare Professionals 108
7.3 Main Factors Affecting Job Satisfaction 110
7.3.1 Career Management 110
7.3.2 Strategic Management and Support I l l
7.3.3 The Nature of the Work Itself. 112
7.3.4 Interpersonal Dynamics 113
7.4 Level of Job Satisfaction across the Demographic Variables 114
7.5 Correlation between Job Satisfaction and Propensity to Leave 115
CHAPTER 8: RECOMMENDATIONS
8.1 Recommendations 118
CHAPTER 9: LIMITATIONS OF THE STUDY AND DHtECTIONS
FOR FUTURE RESEARCH
9.1 Limitations of the Study 123
9.2 Directions for Future Research 124
REFERENCES 126
APPENDICES
Appendix A: Job Satisfaction Survey among Health Care Professionals in
AMHUKZN 137
Appendix B: Original Job Satisfaction Questionnaire 143
Appendix C: Item Analysis of Job Satisfaction Questionnaire 146
Appendix D: Ethical Clearance UKZN 150
rx
LIST OF TABLES
Table 4.1 Face Validity of Job Satisfaction Questionnaire
Table 5.1 Breakdown of Sample by Gender
Table 5.2 Breakdown of Sample by Age
Table 5.3 Breakdown of Sample by Tenure
Table 5.4 Breakdown of Sample by Marital Status
Table 5.5 Breakdown of Sample based on whether Respondents have Children
Table 5.6 Total Variance of Main Components
Table 5.7 Component One
Table 5.8 Component Two
Table 5.9 Component Three
Table 5.10 Component Four
Table 5.11 ANOVA: Gender
Table 5.12 ANOVA: Age
Table 5.13 ANOVA: Tenure
Table 5.14 ANOVA: Marital Status
Table 5.15 ANOVA: Children
Table 5.16 Pearson Correlation: Job Satisfaction and Propensity to Leave
x
LIST OF FIGURES
Figure 2.1 Needs Theory: A Comparison
Figure 2.2 Hertzberg's Theory: Factors Affecting Job Satisfaction
Figure 2.3 Stages in the Process of Voluntary Separation
Figure 5.1 Means Plot: Gender
Figure 5.2 Means Plot: Age
Figure 5.3 Means Plot: Tenure
Figure 5.4 Means Plot: Marital Status
Figure 5.5 Means Plot: Children
LIST OF ACRONYMS
SAMHS - South African Military Health Services
AMHUKZN - Area Military Health Unit KwaZulu-Natal
SANDF - South African National Defence Force
DOD - Department of Defence
SAMS - South African Medical Services
SADF - South African Defence Force
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CHAPTER 1
INTRODUCTION
1.1 INTRODUCTION
The South African National Defence Force (SANDF) comprises four arms of service:
the Navy, the Army, the Airforce and the Medics. The medical core is known as the
South African Military Health Services (SAMHS).
The SAMHS provides military health support to deployed Department of Defence
(DOD) members and essential military health services to the SANDF, its members
and their dependants. The SAMHS capability consists of deployable medical units,
area military health services, specialist services and facilities, as well as logistic
support and operational and medical support capabilities. The output of the area
military health services is to provide a comprehensive, excellent, self supporting,
multi-disciplinary area military health service through a formation headquarters
commanding and controlling nine area military health units to ensure a healthy
military community (DOD, 2003, paragraph 29). Area Military Health Unit (AMHU)
KZN is one of the nine military health units providing a military medical service.
Internationally, healthcare has undergone much change, which has led to stakeholders
demanding a more efficient and effective service delivery. Healthcare professionals,
both caregivers and administrators, are thus required to improve the quality of care
delivered to communities whilst promoting and maintaining a high standard of
professional ethics (Spytak, Marsland and Ulmer, 1999:26).
Within a South African perspective, the White Paper on Transformation of the Public
Sector published on 15 November 1995 by the Department of Public Service and
Administration, addresses the need for transformation in the delivery of public
services. The aim of this transformation process is to improve the efficiency and
effectiveness of the way in which public services should be rendered. It urgently
seeks to introduce a fresh approach to service delivery- an approach which:
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• Puts pressure on systems, procedures, attitudes and behaviour within the
public service.
• Frees up the energy and commitment of public servants to introduce more
customer- focused ways of working.
This enhanced service delivery approach has been encapsulated in the name, "Batho
Pele", (a. Sesotho adage meaning: "People First"). The SAMHS as a public service
healthcare organisation within the South African Department of Defence is also
governed by the White Paper on transformation, and is constantly reminded of the call
for improved service delivery and putting the Principles of "Batho Pele" into practice.
The new Surgeon General of the SAMHS has also emphasised that the government's
imperative of "Batho Pele" (People First) will receive priority, particularly in the
manner that patient care is provided (Ngqakayi, 2005, paragraph 5). The other area of
priority was ensuring the ongoing process of transformation and representivity of the
SAMHS in keeping with a democratic South Africa (Ngqakayi, 2005, paragraph 5).
However a major concern raised, with regard to the transformation of SAMHS, was
the brain drain experienced as more white personnel with expertise left the service.
This is especially important in view of the dire shortage of suitably qualified black
professionals. The loss of expertise could inevitably negatively affect the combat
readiness of the SANDF at a time when its role is rapidly changing in view of its
commitment to the African Union (Madasa, 2003, paragraph 3).
Therefore, the sweeping changes experienced with the political transformation of the
SAMHS and the subsequent brain drain places increased pressure on healthcare
professionals to ensure the effective, efficient and economic use of resources, making
them acceptable and accountable to their stakeholders. The perceived low employee
morale and satisfaction displayed among healthcare professionals could make it
difficult to realise the mission of SAMHS.
An integral part of optimising service delivery in SAMHS and putting the principles
of Batho Pele into practice is to ensure employee satisfaction among the healthcare
professionals. Spytak et al (199956) noted that satisfied employees tend to be more
2
productive, creative and committed to their jobs, and have shown a direct correlation
between employee satisfaction and customer satisfaction. According to Spytak et al
(1999:26), organisations that can create work environments that attract, motivate and
retain hard working individuals will be better positioned to succeed in a competitive
environment that demands quality and cost-efficiency. Schenke (2001:8) also agrees
that it is critical to understand that an interdependent relationship exists between
employee satisfaction and customer satisfaction, and that an organisation needs to
focus on both these assets. Strategies that narrowly focus on 'customer service' will
in the long term succumb to the law of interdependence. Customer service driven
organisations will burn up their financial and employee assets unless they are attended
to in equal measure (Schenke, 2001:8).
In light of this the SAMHS needs to recognise that the healthcare professionals are the
key to improving health service delivery and customer satisfaction. Therefore, it is
important to look at job satisfaction of healthcare professionals in the SAMHS and
first address the issues affecting job satisfaction as this would ultimately impact on
customer satisfaction in the SAMHS.
1.2 RESEARCH PURPOSE
The aim of this study is to identify the key factors that affect job satisfaction among
healthcare professionals in AMHU KZN. A further objective of the study will be to
explore the relationship between job satisfaction and propensity to leave. This would
highlight the issues that need to be addressed in order reduce turnover of professionals
and to create a working environment that contributes to excellence in health care.
1.3 OBJECTIVES OF THE STUDY
The following are the specific objectives of the study:
a) To determine the major contributing factors that affect job satisfaction.
b) To determine if there are differences in terms of job satisfaction among
health care professionals across the different demographic variables.
c) To explore the correlation between job satisfaction and intention to leave.
1.4 OVERVIEW OF THE RESEARCH REPORT
This dissertation is structured as follows:
Chapter 2: Literature Review
The aim is to introduce and define the concept of job satisfaction and
to examine the major theories of job satisfaction that form the
theoretical foundation for the understanding of job satisfaction. The
second part of chapter two will review the relationship between
demographic variables and job satisfaction, and the last part of chapter
two will look at job satisfaction and turnover.
Chapter 3: Background to the Organisation
This chapter reviews the background to the Department of Defence
(DOD) and the SAMHS, as this provides insight into the current issues
in the organisation that could relate to job satisfaction among
healthcare professionals in AMHU KZN.
Chapter 4: Research Methodology
An overview of the methodology used in examining job satisfaction in
respect to the objectives of the study is described in this chapter. This
chapter includes an overview of the research instruments used and the
data collection methods.
Chapter 5: Results of the Study
The data obtained from the job satisfaction questionnaires were first
analysed. The analysis of the demographic data provided a description
of the sample. The principal component method and annova's were
used to in analysing the first two first two objectives of the study. The
propensity to leave questionnaire was also analysed and the Pearson's
correlation was used to determine if there was a correlation between
job satisfaction and propensity to leave. The various statistical tests
used to test the data are discussed. The research findings are presented
as per objective of the study.
4
Chapter 6: Discussion of Results
This chapter deals with a discussion on the results of each objective of
the study.
Chapter 7: Conclusions
This chapter includes conclusions on each objective of the study.
Chapter 8: Recommendations
This chapter includes recommendations of the study
Chapter 9: Limitations and Directions for Future Research
This chapter deals with limitations of the present study and explores
directions for future research.
5
CHAPTER TWO
THEORIES OF JOB SATISFACTION
2.1 INTRODUCTION
The structure of this literature review will be to first explore the concept of job
satisfaction and the job satisfaction theories, to gain an understanding of theoretical
foundations of job satisfaction. It should be noted that relatively old references have
been used in the first part of this literature review as it dates back to the early
theoretical frameworks and studies on job satisfaction. This traditional job
satisfaction research was the foundation upon which a great deal of research has since
developed. It should be noted that in the early literature the theories of motivation
were also referred to as the theories of job satisfaction. Both these terms were used
interchangeably. Reference has been made to the theories of job satisfaction in the
literature review. The second part of the literature review will examine the
relationship between job satisfaction and demographic factors while the last part of
the literature review will look at job satisfaction and turnover.
2.2 THE CONCEPT OF JOB SATISFACTION
The concept of job satisfaction has been explored from varying points of view by
researchers.
According to Vroom (1964:99), the terms 'job satisfaction' and 'job attitudes' appear
to be closely related and are often used interchangeably in many research studies.
Both refer to affective orientations by an individual toward work roles they occupy.
Positive attitudes toward the job are considered equivalent to job satisfaction and
negative attitudes toward the job are equivalent to job dissatisfaction. Locke
(1976:701) also defined job satisfaction as the positive or negative attitudes held by
individuals toward their jobs.
According to Robbins (1979:44-47) values are preconceived views that generally
influence behaviour and they lay the foundation for the understanding of altitudes.
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Beliefs are made up of facts, opinions and general knowledge that one holds about an
object. Beliefs added to values, result in attitudes. Attitudes are more specific than
values, and they also have an evaluative component that beliefs lack. Research has
shown that the values that people have can explain their attitudes and in many cases
their behaviour. Attitudes like values are acquired from parents, teachers and peer
group members. In contrast to values, attitudes are not as stable due to changing
beliefs that individual's experience (Robbins, 1979:44-7).
Greenberg and Baron (2003:147-149) noted that attitudes are composed of three
major components: an evaluative component, the cognitive component and the
behavioural component. The evaluative component refers to an individuals' liking, or
disliking of any particular person, item or event (also known as the attitude object or
the focus of ones attitude). Attitudes involve more than just feelings they also involve
knowledge - that is, what one believes about a person, item or event, whether they are
true or false. For example an individual may believe that a coworker earns a better
salary than he does, and it is this belief, which may or may not be accurate, that
comprises the cognitive component of attitudes. The behavioural component of
attitudes is the predisposition to behave in a way consistent with ones beliefs and
feelings about an attitude. However, such a predisposition may not predict one's
behaviour. An example is if an individual's supervisor is involved in fraudulent
activities the individual might seek alternate employment if he is unhappy with the
situation. However, the individual will not accept the new job if there are other
aspects of his job that compensate for the negative feelings. Therefore the intention to
behave in a certain way may or may not dictate how one would actually behave
(Greenberg and Baron, 2003:147-149).
Based on the various components of attitudes, 'attitudes' is defined as a relatively
stable cluster of feelings, beliefs and behavioural intentions toward specific objects,
people or institutions(Greenberg and Baron, 2003:148). Work related attitudes are
attitudes relating to any aspect of work or work setting. The various attitudes people
hold toward their jobs are referred to as job satisfaction (Greenberg and Baron,
2003:148). Job satisfaction is not behaviour but is considered a general feeling of
contentment with the effort-reward relationship on the job (Robbins, 1979:53).
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Gruneberg (1976:36) describes the traditional model of job satisfaction as consisting
of the total body of feelings that an individual has about his job. An individual
weighs up the overall variables of the job, such as the nature of the job itself, the pay,
the promotion prospects, the nature of supervision and so on. When the sum total of
the variables, give rise to feelings of satisfaction, the individual is satisfied with his
job and when in total the variables reflect feelings of dissatisfaction it implies that the
individual is dissatisfied with his job. This model looks exclusively at the situational
variables in understanding job satisfaction.
However, according to Zaleznik, Christensen and Roethlisberger (1958:256-9),
researchers can study satisfaction from two extreme points of view. One view is the
assumption that an individual is an organic whole who perceives his world as a
totality rather than as isolated experiences. This means that the individual's level of
satisfaction or dissatisfaction is determined by the situation in every aspect of his life,
including the situation in both his work and home front. The feeling of satisfaction or
state of mind of an individual cannot be viewed in isolated parts. The level of
satisfaction at work will affect the individual's level of satisfaction in other aspects of
his life. Measuring satisfaction from this point of view would mean that a researcher
would have to conduct in depth interviews with an individual to study his behaviour
intensely, to view the world as he views it and to understand the meaningfulness of
his experiences. Although this approach would provide valuable information, the
challenge is that measurements and comparisons become difficult and imprecise.
According to Zaleznik et al (1958:259) another point of view is that an individual's
satisfaction can be separated into discrete parts. Worker satisfaction can be divided
into various work roles such as his job, his pay, his supervision, and the organisation
he works for. The advantage of this approach is that the worker is able express his
degree of satisfaction with each of the elements enabling the researcher to conduct
measurements and make appropriate comparisons.
Vroom (1964:172-4), does not believe that job satisfaction should be studied from
separate points of view. Although he recognises that most of the research on the
causes of job satisfaction is based on the assumption that differences in job
satisfaction are due exclusively to differences in work roles. Another assumption is
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that differences in job satisfaction are a direct result of individual differences in
personality. Individuals differ greatly in their motives, values and abilities and it is
thought that it is these differences that affect the attractiveness of the work roles of
people occupying it. However, Vroom is of the opinion that neither of these
variables, one based on situational and the other on personality variables, can be
viewed separately in the understanding of the causes of job satisfaction. He believes
that job satisfaction must be assumed to be the result of both the situational and
personality variables.
This point of view is similar to Porter and Lawler. Porter (1961:3) never developed
an actual theory of satisfaction; however he sees satisfaction as the difference between
what a person thinks he should receive and what he feels he actually does receive.
According to Lawler (1973:82) the research on the determinants of job satisfaction
has focused primarily on two relationships. This was the relationship between
satisfaction and the characteristics of the job and the relationship between satisfaction
and the characteristics of the person. This is in keeping with Lawler's approach to
satisfaction, which he views as both a function of the person and the environment.
Porter and Lawler indicate that personal factors influence what individuals feel they
should receive and that job conditions influence both what people perceive they
actually receive and what people perceive they should receive.
It is important to distinguish what is meant by factor or facet satisfaction and overall
job satisfaction. According to Lawler (1973:64) facet satisfaction refers to people's
affective responses to certain aspects of their jobs. The most common facets are job
content, supervision, financial rewards, promotions, working conditions, and co
workers. Job satisfaction on the other hand refers to a person's affective reaction to
his total work role. It is important to distinguish between facet satisfaction and job
satisfaction as many of the theories on job satisfaction argue that job satisfaction is a
result of some combination of an individual's affective reaction to the various facets
oftheirjobs.
The implications for the current study is that when looking at the first objective of the
study, namely exploring the main factors affecting job satisfaction, the various facets
or situational variables of job satisfaction will be examined. As mentioned earlier the
advantage of this approach is that it allows for easy and accurate measurements and
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comparisons. In examining the relationship between job satisfaction and job
behaviour, such as propensity to leave, an overall job satisfaction score based on the
combination of an individuals overall reaction to the various facets of their jobs, will
be used.
2.3 THEORIES OF JOB SATISFACTION
Gruneberg (1979:9) describes, two categories of theory regarding job satisfaction,
content theories and process theories. Content theories give an account of the factors,
which influence job satisfaction. Process theories attempt to explain the process by
which the variables such as expectations, needs and values interact with
characteristics of the job to produce job satisfaction.
According to Schermerhorn, Hunt and Osborn (1997:86) content theories profile
different needs that may motivate individual behaviour. These theories suggest that a
manager's job is to create a work environment that meets individual needs. It also
explains how poor performance, undesirable behaviour and low satisfaction are
actually a result of'blocked' needs, or needs that are not satisfied on the job. This
includes Maslow's Needs Hierarchy theory, Alderfer's ERG theory, McClelland
Achievement theory and Hertzberg's Two-Factor theory of job satisfaction. The
process theories seek to understand the thought processes that influence behaviour.
Whereas the content theories identify the different needs important to individuals, the
process approach analyse how these needs lead the person to behave in particular
ways relative to available rewards and work opportunities. The process theories that
will be discussed include the equity theory, expectancy theory, reference group theory
and the need and value fulfillment theory.
2.3.1 CONTENT THEORIES
2.3.1.1 Maslow's Needs Hierarchy Theory
According to Locke (1976:88), probably the best-known conceptualisation of human
needs in organisations has been proposed by Abraham Maslow. Maslow was a
clinical psychologist who developed the needs hierarchy theory. In his view people
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that grew up in an environment in which their needs were not met, would find it
difficult to function as healthy, well-adjusted individuals. In applying this idea to
organisations, his premise is that unless people get their needs met on the job, they
will not function as effectively as possible. Maslow's theory specifies that there are
five human needs and that these are activated in a hierarchical manner. These needs
are basic physiological needs, safety and security needs, social (affection) needs,
esteem needs and self-actualisation needs (Greenberg and Baron, 2003:192).
Physiological Needs
These needs lie at the bottom of the hierarchy; they are the lowest order, most basic
needs specified by Maslow. These refer to the basic needs for survival, such as food,
air, water and shelter. To satisfy these needs organisations must ensure that they are
paying their employees a living wage. Periods of rest such as lunch and tea breaks
and opportunities to engage in physical activities such as the use of physical and
exercise facilities are also important for people to meet their physiological needs.
Employee wellness has become a focus of most organizations with the provision of
exercise and physical fitness programs for employees, to encourage them to maintain
a healthy lifestyle (Greenberg and Baron, 2003:192).
Safety Needs
This forms the second level of needs in Maslow's hierarchy. Safety needs refer to the
need for a secure environment that does not pose any threat of physical or
psychological harm. Organisations can ensure that safety needs are met, by example
providing employees with the necessary safety gear like thermal suits for those
exposed to extreme temperatures, life and medical insurance cover, and protection
forces like the police and fire protection. Jobs that provide no lay off agreements also
provide a psychological security blanket that helps to satisfy safety needs. It is
practices like these that create a safe and secure environment that enable people to
function effectively without fear of harm (Greenberg and Baron, 2003:193).
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Social Needs
If the physiological and safety needs are fairly well satisfied, the needs for
belongjngness and love will emerge and dominate motivated behaviour (Arkes and
Garske, 1977:101). These needs refer to the need to be affiliative, to have
affectionate relationships with others such as friends and to be loved and accepted by
other people (Greenberg and Baron, 2003:193). Maslow emphasises that satisfaction
of these needs requires both receiving and giving love. If these needs are not met they
may lead to feelings of rejection, ostracism, loneliness and friendlessness, and
continued deprivation may lead to severe psychopathology (Arkes and Garske,
1977:101). Social needs can be met in organisations by encouraging participation in
social events, such as office braais or parties. An organisations sports club is also a
good opportunity for meeting social needs, by giving employees a chance to socialise
and develop friendships (Greenberg & Baron, 2003:193).
Esteem Needs
The fourth level of needs is esteem needs. This can be divided into two subsets, self-
esteem and esteem of others. The former includes the need for strength, achievement,
competence, independence and so forth. The latter includes needs such as status,
prestige, recognition, attention and appreciation (Arkes and Garske, 1977:101).
Companies can satisfy the esteem needs of individuals in various ways. They can for
example have an awards evening to recognise high achievers, or monetary bonuses
for improved employee performance. Non-monetary awards, such as trophies,
commendation certificates also can be used to acknowledge the valuable contribution
of employees and fulfill esteem needs. Employee of the month, or articles in a
company's newsletter describing an employee's success are also some examples of
things that can be done to satisfy esteem needs (Greenberg and Baron, 2003:193).
Self-Actualisation Needs
The uppermost need in Maslow's hierarchy is a need that is aroused only after all the
lower-order needs have been met - the need for self actualisation. This refers to the
need to become everything that one is capable of becoming; to develop one's fullest
12
potential (Greenberg and Baron, 2003:194). (Maslow, 1970 cited in Greenberg and
Baron, 2003: 194) describes it in much the same way, "what a man can be, he must
be". According to Greenberg and Baron (2003:193) self-actualised employees work at
their maximum creative potential, and are therefore extremely valuable to an
organisation. These individuals work at their peak affording the company maximum
benefit from their human resources. Managers can emphasise self-actualisation by
using techniques that make-work more meaningful. These techniques include
planning special assignments that capitalise on employee's unique skills, or allowing
the employees flexibility in designing work procedures and plans for implementation
(Hellriegel and Slocum, 1979:400).
Controversies regarding Maslow's Theory
Maslow theorised that lower order needs must be met before man is capable of being
concerned with fulfilling higher order needs, a concept called pre-potency (Gawel,
1997, paragraph 6). In his view people are concerned with satisfaction of their needs
according to a system of priorities, which are divided into growth and deficiency
needs. Deficiency needs are the lower order needs such as hunger, thirst, safety and
security, which must be satisfied before higher order needs or growth needs such as
self-respect and self-actualisation can be satisfied. Maslow also felt that once a need
is satisfied it is no longer of importance and the individual will then seek to move up
the hierarchy toward satisfying other needs (Sanzotta, 1977:28).
However, Locke (1976:92) has pointed out that there is some evidence that the
satisfying of some needs lead to a strengthening of those needs, rather than the
reverse. Although Maslow did not in fact develop his theory to explain job
satisfaction, a number of theorists have applied his theory in this way. Applying this
theory to a job situation would imply that an employee will be unable to seek
satisfaction and achievement from the work itself, until his lower order needs for
security and pay have been satisfied (Gruneberg, 1979:10).
Research has also shown that not all people are able to satisfy their higher order needs
on the job. The findings indicate that lower level managers are able to satisfy only
their deficiency needs on the job, while managers from higher up the structure of an
organisation are able to satisfy both their deficiency and growth need. In terms of
13
growth needs there is no urgency to attain a particular goal, rather there is a gradual
move toward the actualisation of potential. At this stage of growth motivation,
individuals are not just motivated but metamotivated (Arkes and Garske, 1977:101).
The importance of the different needs have also been questioned. Many researchers
have tried to measure the importance of the different employee needs. Studies have
shown that the fulfillment of needs differs depending on factors such as the job a
person performs in the organisation, his or her age, race, the size of the company, and
the cultural background of the employee. Briefly these studies have found:
• Line managers perceive greater fulfillment than do staff managers in areas of
security, affiliation, esteem and self-actualisation needs. The largest difference
between line and staff managers occur in esteem and self-actualisation needs
(Porter, 1963:141-148).
• Young workers (twenty five years old or less) have greater need deficiencies than
do older workers (thirty six years old or more) in esteem and self-actualisation
needs (Altimus and Tersine, 1973: 53-66).
• There is a greater lack of need fulfillment in every need among black managers
than their nonblack counterparts (Slocum and Strawser, 1972:28-33).
• At lower levels of management, small-company mangers are less deficient in their
needs than are mangers mat work for larger companies (Porter, 1963:3 86-397).
• Workers from different cultures have different hierarchies in their companies
(Slocum, Topichak and Kuhn, 1971:435-445).
Locke (1976:93) has indicated that, although Maslow's theory has great intuitive
appeal it has some major drawbacks. Firstly there is no evidence for a hierarchy of
needs. In general, Maslow's theory has not received a great deal of support with
respect to his view of the exact needs that exist and the order in which they are
activated.
14
Researchers have also questioned whether it is not more likely that various needs
could be present and attended to simultaneously. In such a situation where the needs
are interrelated the hierarchy as proposed by Maslow would not be applicable. The
hierarchy of needs would be applicable if it was individually determined with a
general common needs arrangement which was more flexible than what Maslow
proposed (Sanzotta, 1977:51).
Application of Maslow's Theory
Despite the controversies, the implication of Maslow's theory provides useful insight
for managers and organisational leaders. Firstly, it is important for managers to look
at ways of motivating employees by devising programs or practices aimed at
satisfying emerging or unmet needs. Another implication is for organisations to
implement support programs and focus groups to help employees deal with stress
especially during more challenging times and taking the time to understand the needs
of the respective employees (Kreitner and Kinicki, 1998:173).
According to Steers and Porter (1983:32), "managers have the responsibility to create
a proper climate in which employees can develop to their fullest potential. Failure to
provide such a climate would theoretically increase employee frustration and could
result in poorer performance, lowered job satisfaction, and increased withdrawal from
the organisation".
2.3.1.2 Alderfer's Need Theory
In response to the criticisms of Maslow's theory, Alderfer adopted an alternative
approach. Alderfer's theory differed from Maslow's theory in three basic respects.
Firstly there are only three types of needs instead of five, this includes the existence
needs- the desire for physiological and material well-being, relatedness needs - the
desire for satisfying interpersonal relationships and growth needs - the desire for
continued personal growth and development. Secondly, although Maslow proposes
that individuals move up the hierarchy as the result of the satisfaction of lower order
needs, Alderfer's ERG theory includes a unique frustration-regression component.
This suggests that an already satisfied lower level need can become activated when a
15
higher level need cannot be satisfied. An example is if a person is constantly
frustrated in his or attempts to satisfy growth needs, relatedness needs can again
surface as key motivators. Thirdly, unlike Masiow's theory, Alderfer's theory
suggests that more than one need may be activated at the same time (Schermerhorn, et
al 1997:90).
According to Greenberg and Baron (2003:194-5) the five needs of Masiow's theory
correspond with the three needs of Alderfer's ERG theory as shown in Figure 2.1.
The existence needs correspond to Masiow's physiological needs and safety needs.
Relatedness needs correspond to Masiow's social needs, including the need for
meaningful social relationships. Lastly, the growth needs correspond to the esteem
needs and self-actualisation needs in Masiow's theory - the need for reaching one's
potential.
Fig 2.1 Need Theories: A comparison
Growth needs
5. Self-actualisation needs
4. Esteem needs
)eficiency needyV
3. Social needs
T. 2. Safety needs
31 1. Physiological needs
Growth
Relatedness
Existence needs
Masiow's Need Hierarchy Theory
Alderfer's ERG Theory
16
The ERG theory has made a valuable contribution to the current body of knowledge
of human needs, in particular the allowance it makes for regression back to lower
level needs. It does help in explaining why in some situations the focus of workers'
complaints is primarily on wages, benefits and conditions of work- things related to
existence needs. Even though these are important issues it may be exaggerated due to
the fact that the jobs do not satisfy relatedness and growth needs. The ERG theory is
therefore, a more flexible approach in understanding human needs than Maslow's
strict hierarchy (Schermerhorn et al, 1997:90). However, although both theories are
not in complete agreement about the exact number of needs and the relationships
between them, they do agree that satisfying human needs is crucial in motivating
behaviour on the job (Greenberg and Baron, 2003:195).
2.3.1.3 Hertzberg's Two Factor Theory
Related to Maslow's needs hierarchy theory is Hertzberg's well known Two Factor
Theory of job satisfaction. According to Hertzberg there are two classes of factors
involved in job satisfaction. These are referred to as motivators (satisfiers) and
hygiene factors (disatisfiers). The satisfiers relate to what a person does while
dissatisfiers relate to the situation in which the person does what he or she does.
(Gawel, 1997, paragraph 6).
According to Grobler, Warnich, Carrell, Elbert and Hatfield (2002:107-8) hygiene
factors such as salary and working conditions, reflect the context of the job. They are
external to the employee and the job and are considered extrinsic conditions of the
job. This means that they are controlled by someone other than the employee.
Motivators on the other hand are intrinsic in nature and they reflect the content of the
job. Managers do not dispense them to employees, but rather each employee controls
and administers them personally. Figure 2.2 illustrates both the hygiene and
motivator factors affecting job satisfaction according to Hertzberg's Theory.
17
Figure 2.2 Hertzberg's Theory: Factors Affecting Job Satisfaction.
Hygiene needs
Reflect job context and lower-level needs
Motivator needs: Reflect job content and higher-level needs
Negative job environment creates demands for
Positive job opportunities allow worker to achieve
Hygiene factors: More money Better supervision Good working conditions Job security Consistent management policies and rules
Motivators: Achievement Responsibility Growth Work Itself Recognition
Which Influence
•
Which Influence
Level of job dissatisfaction
Level of job performance
Level of job satisfaction
Motivators are factors which if present in the working situation, lead to satisfaction,
but if absent does not lead to dissatisfaction. Such factors include achievement,
recognition, and the intrinsic interest of the work itself, and are linked to the higher
levels of'self autonomy' and 'self-actualisation' in Maslow's hierarchy of needs.
These higher order factors differ from the second group of factors, known as the
hygiene (or maintenance) factors, which when inadequate, lead to job dissatisfaction,
but which when adequate do not lead to job satisfaction (Gruneberg, 1979:11-13).
This is the achievement of a neutral point, which is considered a "fair day's work".
At his point there is no difference in performance as a result of motivation. Although
adequate hygiene on the job does not result in job satisfaction, it does serve as a
prerequisite for satisfaction. It is at his neutral point that the employees are prepared
for the factors, which are considered motivators (Sanzotta, 1977:26).
Hygiene factors include pay, security and physical working conditions and correspond
to the lower order needs in Maslow's hierarchy. In separately identifying these two
classes of job satisfaction in this way, Hertzberg argues that the causes of job
satisfaction and dissatisfaction are separate and distinct. The hygiene factors such as
working conditions do not result in a feeling of satisfaction if they are good, however
18
if it is bad it does lead to job dissatisfaction. However, job satisfaction can be
achieved if an individual is allowed to "grow" psychologically, that is, to achieve a
worthwhile aim, and to receive due recognition for his work, so that he can regard
himself as a worthwhile individual. The absence of such factors does not lead to
dissatisfaction, but it fails to achieve satisfaction (Gruneberg, 1979:11-12).
According to Hertzberg (1966:81) mentally healthy individuals will seek
psychological growth from their jobs, and he views those who seek satisfaction from
hygiene factors as having characteristics that lead to neurotic personalities. However,
it has been argued that in several situations where psychological growth has not been
possible due to the dull and routine nature of a job, individuals do gain satisfaction
from hygiene factors such as money. This can be regarded as a healthy adjustment
and is not indicative of a neurotic personality.
Furthermore, several studies have indicated that cultural factors also influence job
satisfaction. In some cultures money is seen as the most important aspect of a job,
therefore these hygiene seekers should not be viewed as individuals with poor
adjustment (Gruneberg, 1979:14-15). Locke (1976) does not support Hertzberg's
ideas on mental health. In his view a lack of self-esteem rather than the failure to
cope with hygiene factors, would more likely be a major factor in neurosis.
One of the major criticisms of Hertzberg is that he has not emphasized the importance
of individual differences in acquiring an understanding of job satisfaction and it is
here where the process theories of job satisfaction, have made a significant
contribution. The process theories attempt to give an account of how the individual's
needs, values and expectations interact with the job to provide job satisfaction and
dissatisfaction. It would be incorrect to consider the job itself in terms of
opportunities for psychological growth without looking at the individual who will
occupy the job and who will vary in terms of the values he wishes fulfilled in the job
(Gruneberg, 1979:31).
Another criticism of Hertzberg's theory is that it does not indicate how the hygiene
factors and motivators will be weighted together to produce an overall assessment of
job satisfaction. However, it does highlight the importance of analysing the
19
characteristics of the work itself in gaining an understanding of job satisfaction
(Gruneberg, 1979:18).
Research into Hertzberg's two-factor theory has produced mixed results. Some
studies have shown that job satisfaction and dissatisfaction were based on different
factors and these conform to the distinct motivators and hygiene factors suggested by
the theory (Machungaws and Schmitt, 1983:31-37). Other studies support the view
that certain hygiene factors can contribute to job satisfaction, and certain motivators
can contribute to dissatisfaction, thereby casting doubt on the two-factor theory. In
light of these mixed results Hertzberg's two-factor theory can be considered an
interesting but unverified framework for understanding job satisfaction (Machungaws
and Schmitt, 1983: 31-37).
However, the two-factor theory is still important in its application in managing
organisations. Managers should focus on motivators, such as the opportunity for
personal growth of individuals and development of professional skills on the job.
Steps should also be taken to look at hygiene factors or create conditions that prevent
dissatisfaction. Creating a pleasant working environment is one example of how to
prevent people becoming dissatisfied with their jobs. Research has shown that
dissatisfaction is quite pronounced under conditions of overcrowding, poor lighting,
high noise levels, extreme temperatures and poor air quality. The hygiene factors will
not improve motivation. According to the Hertzberg approach the only way to
motivate employees is to upgrade their jobs. Hertzberg has shown strong support for
job enrichment, as a means of tapping the motivational potential within every worker
(Sanzotta, 1977:27).
2.3.1.4 McClelland's Need Motivation
David McClelland looked at the distinctly human phenomenon of constructive
activity beyond survival requirements, and identified this trait as the "need for
achievement" (n Ach). According to Hellriegel and Slocum (1979:404), achievement
motivation can be defined as the desire to perform in terms of a standard of excellence
or a desire to be successful under competitive conditions. The level of achievement
20
motivation of people is influenced by their childhood, personal and occupational
experiences, and the type of organisation that an individual is working for.
The socio-economic background of these individuals is important. High achievers
tend to come from a middle class background, in which competence is expected, and
independence is encouraged from an early age (Sanzotta, 1977:25).
Achievement motivation was measured by using the projective technique known as
Thematic Aperception Test (TAT). The TAT asks people to view pictures and write
about what they see (Schermerhorn et al, 1997:90). The main intent of this is to
obtain the individual's own perception of the world. The response to the individuals
perception of the picture, the meaning each subject gives to it and how each subject
organises the stimuli is assessed. McClelland has found that the responses often
indicate each subject's own view of the world, personality structure, needs and
feelings and ways of interacting with others (Hellriegel and Slocum, 1979:406).
McClelland identified three themes that correspond to underlying needs, important in
understanding human behaviour:
• The need for achievement, - which is defined as a preoccupation to focus on
goals, the desire to do something better or more efficiently. Individuals with
the need to achieve often prefer working independently and are often
associated with a lack of group orientation (Grobler, et al, 2002:105).
• The need for affiliation, - the desire to establish warm, friendly interpersonal
relations with others (Schermerhorn et al, 1997:90).
• The need for power- the desire to obtain and exercise control over the
behaviour of others, resources and the environment (Grobler et al, 2002:105).
McClelland found that individuals with a strong need for power and affiliation
demonstrated a propensity for either totalitarian methods of control or more
democratic methods (McClelland and Burnham, 1985:69-71).
Of MclCelland's three needs that have been identified, Sanzotta (1977:25), noted that
professionals usually have a high need for achievement. Carrell, Elbert and Hatfield,
21
(2000:128) found that the need for achievement was the focus in McClelland's
research. This need was highlighted as critical to the success of an organisation, as
most organisations want their employees to achieve.
In the light of the fact that professionals are regarded as high achievers it is important
to understand McClelland's description of high achievers as this would provide
insight for an organisation that is looking at meeting the needs of their employees.
McClelland's description of high achievers are summarised as follows:
• High achievers like to set their own goals, as they are quite selective about the
goals they choose. It is for this reason that they do not automatically accept
goals set by others, including their supervisors. They do not seek advice from
people except from experts in the field. High achievers prefer to remain
accountable for the attainment of goals. If they are successful they would
accept the credit for it and if they are unsuccessful they would accept the
consequences. High achievers prefer to resolve problems rather than leaving
the outcome to chance or to others (Hellriegel and Slocum, 1979:406).
• High achievers tend to choose moderate goals. The goals must not be so easy
that achieving the goal produces minimal satisfaction, but neither must the
goal be unattainable that it no longer provides a challenge (Hellriegel and
Slocum, 1979:406).
• High achievers will prefer situations where they can obtain feedback on
whether or not they have achieved their goals (Sanzotta, 1977:24).
The effect of extrinsic rewards such as money on high achievers is complex. High
achievers do have a high opinion of the value of their services and, therefore, prefer to
receive the pay of a valued employee. High achievers are often good at what they do
and would not remain long in a job that does not pay them equitably for performing
well. Incentive plans do not necessarily improve performance of these individuals as
they are often working at their peak efficiency. Money is a strong symbol of their
22
achievement and adequacy, and may lead to feelings of dissatisfaction if they feel
they their remuneration is low in comparison to others. Achievement satisfaction is
not possible in an organisation where the tasks are routine, boring or where there is no
competition (Hellriegel and Slocum, 1979:407). A high need achiever prefers to work
in organisations where there are individual responsibilities, challenging goals and
performance feedback (Schermerhorn et al, 1997:91).
McClelland has highlighted the importance of high achievers in terms of economic
growth and maintains that underdeveloped countries have populations with low need
for achievement. High achievers often embark on professional careers or in
entrepreneurial activities. Although there is a need for high achievers no organisation
should be made up of only high achievers. There is a need for employees who don't
like taking risks like the finance department, and those who have little responsibility
like assembly line workers. These employees don't require a work environment with
limited restrictions and greater independence to maximise their achievement
satisfaction (Sanzotta, 1977:25).
The content theories above have given an account of the factors, which influence job
satisfaction. In essence the content theories identify the different needs important to
individuals. The process theories in the discussion that follows will analyse how the
needs identified by the content theories lead the person to behave in particular ways
relative to available rewards and work opportunities.
2.3.2 PROCESS THEORIES
Process theories describe job satisfaction as being determined, not only by the nature
of the job and its context, but by the needs, values and expectations that individuals
have in relation to their jobs. The classes of theory that describe this are the
expectations and equity theory, reference group theory and the needs/value fulfillment
theory (Gruneberg, 1979:17).
23
2.3.2.1 Adam's Equity theory
The expectation an individual has about his environment will affect how he or she
behaves. Expectations are a frame of reference by which an individual judges the
world about him. In a job situation, frames of reference can be used when deciding
for example, what is reasonable pay. An individual would compare what they are
receiving to what others are receiving and if they discover they receive less then this
would lead to dissatisfaction. It is only when rewards and efforts are seen as
reasonable compared to the rewards of other people is there satisfaction. This
concept of what is a just reward for one's effort is the crux of the equity theory
(Gruneberg, 1979:20).
The theory proposes that people focus on two variables in determining what is a just
reward, the outcomes and inputs. Outcomes are the rewards employees receive from
their job, such as pay, fringe benefits, prestige and recognition. Inputs refer to the
contributions people make to their jobs such as their experience, qualifications, the
amount of time worked, the amount of effort spent on their jobs and the number of
units produced. Outcomes and inputs are based on the perceptions of people and not
necessarily on any objective standards; therefore there often is debate as to what
constitutes equitable treatment on the job (Greenberg and Baron, 2003:202).
Another way of describing the equity theory is that people strive to maintain ratios of
their own outcomes (rewards) to their own inputs (contributions) that are equivalent to
the outcome/input ratio of others that they compare themselves with. The "others"
that they compare themselves to could be anyone, like other employees in their
section, other employees in the organisation, individuals in the same profession, or
even themselves at an earlier period of employ. These comparisons can result in any
of three different states, overpayment inequity, underpayment inequity, and equitable
payment. Overpayment inequity is a situation that results in feelings of guilt, in
which the ratio of one's outcomes/inputs is more than the corresponding ratio of
another individual with whom that person compares himself or herself.
Underpayment equity is a condition that results in feelings of anger, in which the ratio
of one's outcomes/inputs is less than the corresponding ratio of another individual
with whom that person compares himself or herself. Equitable payment is a state in
24
which the income/output ratios of both individuals are equal, resulting in a feeling of
satisfaction (Greenberg and Baron, 2003:202-203).
People can respond to inequity in behavioural and or psychological ways. These
reactions assist in changing the perceived inequities into a state of perceived equities.
According to the equity theory, if an employee detects a discrepancy in his effort and
rewards compared to others, the employee may lower his input by putting less effort
into his work, taking extended breaks, producing reduced quality goods and so on
(Gruneberg, 1979:20).
On the other hand the employee can raise his outcomes by asking for a raise, or by
taking home the organisation's property, such as equipment and office supplies.
These are specific behavioural reactions in attempting to change inequitable states to
equitable ones (Greenberg and Baron, 2003:203).
However, according to Chung (1977:117) some individuals do not change their
behaviour but rather the way that they think about a situation. Since equity theory is
based on the perceptions one has about fairness or unfairness, it would be reasonable
to expect that inequitable states can be changed, merely by altering a persons'
thinking about the situation. For example, an overpaid person may convince himself
that his outcomes are actually deserved based on his inputs. He may rationalise that
he indeed works harder than the others and therefore his higher pay is justified.
Similarly, underpaid individuals may convince themselves that the comparison
worker is really more qualified and therefore deserves a higher pay. In effect by
changing the way people see things, people can perceive inequitable states as being
equitable, and in so doing reduce their inequity distress. However the limitation of
such cognitive distortion is that it may create a feeling of self-deception and guilt
(Chung, 1977:117).
There is a lot of evidence that suggest that the equity theory is in fact practiced in
many organisations. Research has shown that there is a higher rate of theft from
individuals who have had pay cuts than from individuals who receive regular pay.
According to the equity theory, these individuals may be seen as raising their
outcomes (Greenberg, 1990:568).
25
People's perception of fairness in the organisation is known as organisational justice.
This can be divided into three categories. Distributive justice concerns people's
perceptions of how fairly rewards are distributed. Procedural justice concerns
people's perception of the fairness of the procedures used to determine those rewards.
Interactional justice focuses on people's perceptions of the fairness of the
interpersonal encounters they have with others (Greenberg and Baron, 2002:201). If
employees feel that the organisation is treating them unfairly they will retaliate
against their employees to ensure a more equitable outcome (Skarlicki and Folger,
1997:442). The challenge, therefore, for organisations is to develop reward systems
that are perceived to be fair and equitable and redistributing the reward in accordance
with employee beliefs about their own value to the organisation (Pinder, 1984:186).
The equity theory of satisfaction does not account for all aspects of job satisfaction.
Locke (1976:21) argues that the main drawback of the equity theory is not so much
that it has been shown to be wrong, but that it is so loose that it is able to account for
anything.
2.3.2.2 Reference Group Theory
An important part of the equity theory as discussed above, is that an individual
compares his inputs and outputs of a job with others, like friends, work colleagues and
people in the industry and so on, before judging whether he has been equitably treated
(Gruneberg 1979:21).
Hulin and Blood (1968:41-65) have argued that an understanding of the groups to
whom the individual relates (reference group) is actually critical in understanding job
satisfaction.
A study by Klein and Maher (1966:195-208) also confirms the importance of
reference groups. The study found that college - educated managers were less
satisfied with their pay than non-college educated managers. This could have been
due to college- educated managers having higher expectations of pay because of their
tertiary education and that they related their salaries to other managers with a tertiary
education receiving a high salary.
26
However, there have been a number of concerns that have been raised with regards to
this theory. Some of the questions that remain unanswered are for example, how do
individuals choose which reference group to relate to? Why do reference groups have
the expectations they do? and what constitutes a reference group? It is also quite
apparent that individuals differ in the reference group they choose because of their
own individual personalities, needs and values (Gruneberg, 1979:22).
2.3.2.3 Need/Value Fulfillment Theory
According to Gruneberg (1979:25), "individuals differ in what they value in a job and
this, too, is likely to affect the degree to which they are satisfied." The value theory
suggests that job satisfaction depends to a large extent on the match between the
outcomes individuals' value in their jobs and their perceptions about the availability
of such outcomes. These outcomes refer to anything that the employee regards as
being important.
A number of theorists have shown that the key to satisfaction would depend on the
level of discrepancy between various facets of the job one has and those one wants
(e.g. pay, learning opportunities), the greater the discrepancy, the greater the level of
dissatisfaction. (Greenberg and Baron, 2003:154).
Vroom (1964:56) examined two models of the need fulfillment theory. The first
model is the subtractive model, which states that job satisfaction, is negatively related
to the degree of discrepancy between what the individual needs and the extent to
which the job satisfies these needs. Taking all the needs into consideration, the
greater the total discrepancy, the less the satisfaction, while the greater the
congruence, the greater the satisfaction. The criticism of this theory is that it ignores
the importance of a particular need. Some needs are more important to individuals
than other needs, therefore a view of job satisfaction, which does not take into account
the relative importance of needs, can be misleading. The second model, the
multiplicative model, of need fulfillment takes into account need importance. In this
model the perceived amount of need fulfillment offered by the job is multiplied by the
importance of the need to the individual. The value of each need is then added
together to give a total measure of job satisfaction. The problem with this model is
27
that it fails to distinguish between how much one wants something (its importance)
and how much of something one wants (Gruneberg, 1979:24-26).
An interesting application of the value theory is that it focuses on aspects of the job
that need to be changed to ensure satisfaction. These aspects might not be the same
for everyone but it will include any valued aspects of a job where individuals perceive
serious discrepancies. By emphasising values, this theory implies that job satisfaction
can be derived from many factors. In order to improve job satisfaction, many
organisations conduct surveys to identify sources of dissatisfaction and where
possible provide people with what they want (Greenberg and Baron, 2003:155).
2.3.2.4 The Expectancy Theory
Vroom's model of expectancy theory differs from those of Maslow, McClelland and
Hertzberg in that it indicates a thought process of why individuals choose certain
outcomes while ignoring others. Although it does not provide specific suggestions on
what motivates a person, it does indicate the determinants of motivation and how they
are related (Hellriegel and Slocum, 1979:416).
The expectancy theory of work motivation looks broadly at the role of motivation in
the overall work environment, instead of just focusing on individual needs, goals or
social comparisons. Basically the theory asserts that people are motivated to work
when they expect that they will be able to achieve the things that they want from their
jobs (Greenberg and Baron, 2003:207).
There have been several different interpretations of the expectancy theory by
researchers. However, most expectancy theorists agree that motivation is the result of
three different types of beliefs that people have (Porter and Lawler, 1968:95).
The three key variables of the theory are:
• Expectancy- this is the belief that one's effort will result in performance
(Greenberg and Baron, 2003:207). Expectancy would be rated zero if the
individual felt it impossible to achieve the given performance level, and would
28
be rated 1 if the individual was 100 percent certain that the performance would
be achieved (Schermerhom etal, 1997:95).
• Instrumentality- this is the belief that one's performance will be rewarded
(Greenberg and Baron, 2003:207). Valences can be positive or negative
depending on the results of the outcome and how the individual feels about
this (Hellriegel and Slocum, 1979:413).
• Valence- The perceived value of the rewards to the recipient (Greenberg and
Baron, 2003:207). Valences varies on a scale from -1 (very undesirable
outcome) to + 1 (very desirable outcome) (Schermerhom et al, 1997:96).
According to Vroom, expectancy theory states that motivation is a multiplicative
function of all three components. Motivation (M) = Expectancy (E) x Instrumentality
(I) x Valence (V). This implies that motivation will be high when expectancy,
instrumentality and valence are high and positive. However, the motivational appeal
of a given work path will be significantly lower when either one or more of the
components approaches the value of zero. The multiplier effect requires managers to
act in a way to maximize expectancy, instrumentality and valence when seeking to
create high levels of work motivation through the allocation of work rewards. If any
of the components is equal to zero this will result in zero motivation (Schermerhom et
al, 1997:96).
Research on Vroom's Model
Studies have shown that a persons expectations about job related outcomes could
affect choice behaviour. A study conducted among nursing school graduates found
that nurses choose hospitals that let them satisfy a variety of work related outcomes
(attractive work hours, pay, leisure, work in specialised fields of interest, and
challenging work assignments). Hospitals that gave nurses the opportunity to achieve
these outcomes were chosen by nurses to a greater extent than hospitals where nurses
did not have the opportunity to achieve these outcomes (Sheridan, Slocum and
Richards, 1975:361-368).
29
There is concern over a number of issues concerning the expectancy theory. Firstly,
all the changes made to the basic model have made it too complex to measure.
Secondly, researchers have also used various methods to measure expectancy,
instrumentality and valence, thereby making comparisons between studies difficult.
Thirdly the complexity of the model makes it difficult to test with very few studies
having tested all the variables within the model. Finally research on this model does
not support the multiplier effect of the model, for an individual to be motivated to
exert some effort (Hellriegel and Slocum, 1979:415).
The expectancy model argues that both the attractiveness of the outcomes and the
persons expectancies and instrumentalities influence what type of performance
alternatives an individual will try to obtain. However, the theory does not examine
the question of how the individual develops expectancies and instrumentalities and
what influences them (Hellriegel and Slocum, 1979:415).
Managerial Implications
Based on the expectancy theory managers should try to intervene actively in work
situations to maximise work expectancies, instrumentalities and valences that support
organisational objectives. To influence expectancies managers should recruit capable
individuals, train them well, provide them with the needed resources, and set clear
performance goals. To influence instrumentality managers should clarify
performance-reward relationships and ensure that individuals are actually rewarded
for high performance, so that the individual remains motivated. To influence
valences, managers should identify the needs that are important to each individual
with the emphasis on matching the needs of the employees with the particular
organisational reward (Schermerhorn etal, 1997:97).
2.3.3 Conclusion
The literature review indicates that each theory on job satisfaction has made a
valuable contribution to understanding the concept of job satisfaction. As mentioned
earlier the theories of job satisfaction are the same as the theories of motivation.
These theories of motivation assist in the understanding of job satisfaction. In terms of
30
the current study the content theories would identify the main factors affecting job
satisfaction, while the process theories analyse the behaviour of health care
professionals in response to their levels of job satisfaction. The job satisfaction
theories do indicate that there are a number of facets of a job, which can cause
satisfaction/dissatisfaction, therefore measuring each of these as well as overall job
satisfaction is important. However, it is also important to note that levels of job
satisfaction may differ across employees as each employee may have different
priorities. Therefore, it is important to look at job satisfaction among health care
professionals across the different demographic variables. The next section of the
literature review will examine the demographic differences among individuals and job
satisfaction.
2.4 DEMOGRAPHIC DIFFERENCES AMONG INDIVIDUALS AND JOB
SATISFACTION.
2.4.1 INTRODUCTION
Demographic characteristics are background variables (e.g.; age, gender) that help
shape what a person becomes over time. It is considered to be the heart and soul of
workplace diversity (Schermerhorn et al, 45). According to Moorhead and Griffin
(1995:520) it is important to recognise that diversity exists in organisations before
trying to manage them. The problem that many managers have is that they tend to
stereotype people in organisations. As a result coworkers who differ in race, age,
gender and other ways, and do not share the same beliefs as their managers, may be
treated as 'different'. The danger with stereotypes is that it can often lead to
developing prejudices. Management systems built on stereotypes and prejudices is
inappropriate for a diverse work force.
Stereotypes and prejudices also tend to erode of the individuality of people. The
distinctiveness and individual talent of individuals are minimised, resulting in a loss
of self-esteem, which can lead to lower levels of satisfaction and performance.
People, who are treated as incompetent, do over time begin to believe themselves to
be incompetent, which leads to reduced productivity, lower creativity, and lower
morale. It is therefore important to understand that diversity exists in workforces and
31
manage it accordingly to prevent a workforce that has problems working
cooperatively, is unhappy, disillusioned and underutilised (Moorhead and Griffin,
1995:520).
2.4.2 Gender
Findings on the impact of gender on job satisfaction are inconsistent. While some of
the findings suggest that there are no differences in the level of job satisfaction among
men and women (Mannheim, 1993:138), others do suggest that expectations of
working - women in terms of job satisfaction are different from those of men (Martin
and Hanson, 1985:91).
Some studies have indicated that the effects of gender on job satisfaction vary with
the level at which an individual works. A study by Shapiro and Stern (1975:389)
found that professional women such as clinical psychologists, social workers and
medical workers experienced lower levels of job satisfaction than their male
counterparts. Among nonprofessionals on the other hand the reverse was true.
In support of these results for job satisfaction among men and women depending on
their occupational level, Varca, Shaffer and McCauley (1983:348), also found similar
results in their study, examining job satisfaction among alumni 5 years after they
graduated from college. Results indicated that at higher occupational levels men
expressed more satisfaction than women in terms of pay and opportunities for
advancement. Hagedorn (1996:569) has also presented evidence that the job
satisfaction of female academics is lower when their earnings fall below the earning
of comparable males.
The high cost of living has resulted in an increase in the number of women entering
the workforce and consequently an increase in the number of dual-earner families
(Aryee, 1993:823). The greater educational attainment of women has also resulted in
increased number of women in managerial and professional positions. However,
corresponding social roles and responsibilities have not kept pace. The women still
assume the primary responsibility of child and home care. Movement toward
32
increased family sharing has been very minimal with working parents relying on
extended family or live-in domestic helpers to care for children (Aryee, 1993:823).
According to the gender role theory, women are more likely to see the family role as
part of their social identity than men do (Gutek, et al, 1991:561). Research has shown
that despite women's advancement in the work arena, women are still more likely
than men to take parental leave and feel responsible for the family and home demands
(Judiesch and Lyness, 1999:642). A study on work-family conflict and job
satisfaction has also found that when work is seen as interfering with the time and
energy needed at home, working parents especially working mothers become
dissatisfied with their jobs (Grandey, et al, 2005:306). Consistent with the gender
role theory, several studies have supported the proposition that the relationship
between global work-family conflict and job satisfaction is stronger for women than
for men (Bruck, Allen and Spector; 2002:336-352; Kossek and Ozeki, 1998:139-149).
Therefore gender is an important demographic variable that should be considered in
studies on job satisfaction.
2.4.3 Age
There is often concern over age, learning and flexibility. The older workforce is often
associated with a sense of inertia, whereas studies have found that in reality it depends
on the individual. In fact many older employees have been found to be quite flexible
(McEvoy and Cascio, 1989:16).
Based on a broad review of literature on age, Rhodes (1983:328) concluded that
overall job satisfaction is positively and linearly related with age. Older workers
appear to show greater satisfaction with their employment than younger workers,
however, this form of relationship is not clear. There are also many studies that
suggest a linear relationship (Mottaz, 1987:387-409; Lee and Wilbur, 1985:781-791;
Weaver, 1980:364-367), while other studies (Kacmar and Ferris, 1989:205) reported a
U-shaped relationship. A study by Kalleberg and Loscocco (1983:79), suggest that
satisfaction increases until age 40 then levels off, and then increases again when
employee reach their late 50's.
33
2.4.4 Tenure
Tenure is not a good predictor of productivity. Employees that have been longer in a
job are not necessarily more productive than people with fewer years of service
(Robbins, 1996:85).
There is, however, a positive relationship between tenure, the length of time spent in
the organisation, and job satisfaction. The longer the time spent in the organisation,
the more satisfied managers are with theirjobs. This may indicate that once the
process of acculturation is over, managers settle into theirjobs, have increased
organisational commitment and seem to like theirjobs (Farkas and Tetrick, 1989:855-
860). On the other hand this could be an indication of complacency, suggesting that
the longer the time spent in the organisation, the more managers become accustomed
to the status quo. If the latter is the case, then a satisfied manger is not necessarily a
productive manager. Rotating managers to different jobs reduces complacency and
improves task variety, which has been suggested to be positively related to job
satisfaction (Naumann, 1993:61-81).
Tenure appears to be a more consistent and stable predictor of job satisfaction than
chronological age (Bedeian, Ferris and Kacmar, 1992:36).
2.4.5 Other Demographic Characteristics
Other demographic characteristics that are considered in studies on job satisfaction
are usually able-bodiedness, racial and ethnic groups, marital status, number of
children, and experience. In general the research indicates that married individuals
tend to have fewer absences, lower turnover rates and greater job satisfaction than do
unmarried individuals. A positive relationship has been found between number of
children, and absences and job satisfaction (Schermerhom et al, 1997:45). Studies
have shown that military personnel, who are married and have dependant children, are
less likely to indicate intent to leave the military (Kilburn, Lowie and Goldman, 2001
cited in Antecol and Cobb-Clark, paragraph 37).
34
Racial and ethnic diversity is also an important demographic factor that affects job
satisfaction. Diversity issues are particularly salient for the United States military,
with the military becoming even more racially and ethically diverse over time.
Unfortunately this diversity has resulted in increased reports of racial and ethnic
harassment (Antecol and Cobb-Clark, paragraph 3). Racial harassment has been found
to significantly increase job dissatisfaction irrespective of the type of harassment
considered. Furthermore, threatening racial incidents and career related
discrimination have also resulted in increased intentions to leave the military (Antecol
and Cobb-Clark, paragraph 19).
It is important to ensure that demographics are not used stereotypically, as it can
create problems in an increasingly diverse workplace. It is also important to ensure
that individuals are given a fair chance to demonstrate their true underlying potential
in a work setting (Schermerhorn et al, 45).
2.4.6 Conclusion
The main aim of examining the concept of job satisfaction and exploring further the
demographic variables that affect job satisfaction is to create an awareness of the
problem areas that need to be addressed to improve levels of satisfaction among
employees, which would ultimately reduce the turnover in organisations. The next
section will examine the relationship between job satisfaction and employee turnover.
2.5 JOB SATISFACTION AND EMPLOYEE TURNOVER
2.5.1 INTRODUCTION
"Voluntary employee turnover" is one of the most studied behaviours in management
research (Horn and Kinicki, 2001:975; Griffeth, Horn and Gaertner, 2000:463).
Turnover is a major problem for many organisations as it is extremely costly for the
employer - particularly in jobs which offer higher education and extensive on the job
training (Cascio, 1982:46). Considerable research has been done on voluntary
turnover with intent to quit as a commonly proposed antecedent. Conclusions from
traditional turnover research is that intention to quit work (turnover intention) is the
35
best predictor of actual voluntary turnover in an organisation (Steensma, Van
Breukelen and Sturm 2004:215). Turnover intention is regarded as a conscious
decision and deliberate willfulness to leave the organisation whereas turnover is
understood to be the termination of an individual's employment with a given
company (Tett and Meyer, 1993:263).
Labour turnover has a profound impact on an organisation for three reasons. First, the
main costs of labour turnover are not recruitment and selection, although not
insignificant, but training and development. Second, there is loss of skills and 'core
competence' involving the transfer of skills and knowledge, especially those that are
tacit and informal, from the departing employees to other employees. Third, in order
to ensure an effective strategy for skill formation, labour retention must be high
enough for the average length of service to provide a return on human capital
(Winterton, 2004:371).
2.5.2 A CONCEPTUAL MODEL OF LABOUR TURNOVER
Most conceptual models of voluntary turnover assume that job dissatisfaction is the
main cause of labour turnover, and there are considerable findings of the negative
relationship between employee turnover and job satisfaction (Locke 1975:457-480;
Vroom, 1964 and Brayfield and Crockett, 1955: 396). The traditional approach views
labour turnover as a consequence of low job satisfaction combined with available
labour market opportunities that encourage ease of movement to other more attractive
employment (Price, 1977, cited in Winterton, 2004:373).
Porter and Steers (1973:173) believed insufficient attention had been paid to the
"psychology of the withdrawal process", as a result of which, "understanding of the
manner in which the actual decision is made is far from complete". According to
Porter and Steers an expressed intention to leave represented the next logical step in
the process after experiencing job dissatisfaction. (Mobley 1977, cited in Winterton,
2004:373), however, argued that intention to leave, "following several other steps,
may be the last step prior to actual quitting". Mobley's model proved extremely
influential in developing turnover theory and establishing the importance of
36
intermediate stages between job dissatisfaction and the act of quitting (Griffeth and
Horn, 1988:103-111; Michaels and Spector, 1982: 53-59; Price and Mueller, 1981:
543-565).
Mobley's model involves eight stages before the intention to quit: evaluating the
existing job; experiencing job dissatisfaction; thinking of quitting; evaluating the
expected utility of search and cost of quitting; intention to search for altematives;
searching for alternatives; evaluating alternatives; and comparing alternatives with the
present job. However, theoretical critiques of the Mobley model have suggested that
it is over-specified, detailing elements in the process that are effectively redundant
(Morrow, 1983: 486-500; Arnold and Feldman, 1982: 350-360 and Bluedorn, 1982:
135-153).
In a major advance, another theorist, Lee and Mitchell's (1994) 'unfolding model of
voluntary turnover' expanded the scope and depth of theory on turnover processes.
Lee and Mitchell introduced decision making concepts from 'image theory',
according to which employees conserve mental resources by deliberating less
extensively than is implied in earlier turnover models (Maertz and Campion, 2004:
567). This model shows that factors other than job dissatisfaction can initiate the
process of turnover, and individuals need not compare their current job with
alternatives and that the decision to quit may be based on a compatibility judgment
rather than an evaluation of expected utility (Winterton, 2004:374).
In this model, the initiating action, usually a 'shock to the system', leads employees to
deliberate about turnover. Lee and Mitchell propose five different decision paths.
Path one may entail repeating a response to an event that has occurred before, such as
a female employee leaving due to pregnancy. Path two represents a response to a
shock that causes the employee to re-assess their attachment to the organisation. Path
three involves a shock that causes an employee to consider whether they should form
an attachment with another organisation. Path four, there is dissatisfaction, no shock
and no consideration of altematives, the individual experiences such job
dissatisfaction that they quit regardless of the presence or absence of alternatives.
Path five is essentially identical to path four except that it includes job search and
37
consideration of alternatives (Maertz and Campion, 2004: 567 and Winterton,
2004:374).
Taking into consideration the existing theories of labour turnover, Winterton
(2004:375) proposed a conceptual model of labour turnover and retention that
distinguishes four stages in the processes affecting an individual's intention to quit
and actual separation from the job as represented in Figure 2.3.
Figure 2.3: Stages in the Process of Voluntary Separation
low job satisfaction
intention to quit labour market low job satisfaction
intention to quit opportunities
i r T
| f i w actual quit ease of comn litment
actual quit movement
When job satisfaction is low and perceived opportunities are attractive, an intention to
quit can be translated into actual separation given that there is sufficient ease of
movement and organisational commitment is low. The intention to quit and the actual
separation are influenced by the combined effects of the four factors that occupy the
corners of the diagram in figure 2.3. The extent to which any of the four factors
influence intentions and actual separation will invariably depend upon specific
circumstances and the process can be initiated at any point. Although any of the four
areas could initiate the separation process, turnover is anticipated to be the highest
where all four are relevant (Winterton, 2004:375).
The intention to quit may be triggered by job dissatisfaction (a push effect) or by
perceived alternatives (a pull effect), and in the latter case, job satisfaction may not be
low. The actual quit may be triggered by low commitment irrespective of the level of
job satisfaction, or by the ease of movement to another position (Winterton,
2004:375). Organisational commitment is the degree to which an employee identifies
38
with a particular organisation and its goals and is keen on maintaining membership in
the organisation (Blau, 1986:578). Several studies have looked at job dissatisfaction
and organisational commitment and found organisational commitment to have a
stronger effect on turnover (McFarlane Shore and Martin, 1989:625-640 and Arnold
andFeldman, 1982:350-360).
There could be high turnover even when there is a high level of job satisfaction
because of increased labour market opportunities, low organizational commitment or
ease of movement in any combination (Winterton, 2004:375). A study conducted by
Carsten and Spector (1987:374-381), found that the intention to leave and turnover
relation is moderated by economic alternatives. Low relations between both variables
were found during times of high unemployment and limited employment opportunity
and high relations were found in times of low unemployment and expanded job
opportunities.
There are several factors that affect ease of movement. Studies have found a strong
negative relationship between increased age and turnover (Robinson, 1972:282;
Fanis, 1971:311-328 and Ley, 1966:497-500). Older workers are less likely to resign
as longer service provides them with higher wage rates, longer paid vacations and
more attractive pension's schemes (Robbins, 1996:83). Similarly, increased tenure
appears to be strongly related to propensity to remain. One possible reason could be
that an increase in tenure would mean an increase in personal investment on the part
of the employee in the organization, whereby after a while quitting may not be, a
feasible option. Family size and family responsibility were found to be positively
related to turnover among women while studies among men produced mixed results
(Porters and Steers, 1973:165-167).
2.5.3 PREDICTORS OF EMPLOYEE TURNOVER
Turnover could be the result of unrealistic expectations created during the recruiting
process. It is, therefore, important not to "sell" prospective employees on the
organisation but rather to use realistic job interviews that outline both the good and
bad aspects of the job without any distortion (Schermerhorn et al, 1997:99-100).
Organisations that do not use realistic job previews have been shown to have a 29
39
percent higher turnover rate than organisations that do use realistic job previews
(Reilly, Brown, Blood and Malatesta, 1981:823).
Porter and Steers (1973:151-176) also looked at the causes of turnover. The first
factor was pay and promotion, with sufficient evidence to suggest that low pay and
the lack of promotional opportunity could be the major cause of turnover. The
problem was not just a result of the actual level of pay but also the perceived equitable
level of pay. The situation was similar with regard to promotion procedures with
some occupations showing greater dissatisfaction due to lack of perceived equitability
in their administration.
Although remuneration is viewed as a lower- order, hygiene need, it is still important
to ensure that high performers are adequately remunerated, as replacement costs for
these individuals are high (Winterton, 2004:377). Turnover studies also confirm that
the perceived equitable level of pay in relation to others in the company was a major
factor affecting voluntary quits (Van Yperen, Hagedoorn and Geurts, 1996:429).
Human capital theory also suggests that individuals decide whether to stay with a firm
in part on the basis of whether their jobs provide the best fit with and returns on their
qualifications. As individuals acquire new qualifications they may outgrow their
current jobs, making other options more attractive. A promotion means that their
existing firm has recognised their new qualification and has found them new
responsibilities that are a closer match to their capabilities. Promotions assist in re
establishing a match between employee skills and job requirements, and they should
reduce the attractiveness of other jobs opportunities, independently of wages (Liu,
1984:1137). Other studies have also confirmed that organisations investing in
employees' marketable skills can reduce turnover if individuals acquiring the skills
are subsequently promoted (Benson, Finegold, Mohrman, 2004:315).
Other factors that Porter and Steers (1973:151-176) considered were job content,
supervision and personality factors. Of the job content factors, task repetitiveness was
shown to be related to employee turnover; however this relationship was not found to
be significant. A number of studies did show a relationship between supervision and
turnover. However, two studies found that considerate supervision is only effective in
reducing turnover up to a point, beyond which other factors become important in the
40
decision to withdraw from the job. In terms of individual factors some individuals do
seem to be 'turnover prone'. Often individual's who have no clear idea of where their
vocational interests lie may be more likely to quit their jobs than individual's with
clear ideas. There was also a higher exodus of employee manifesting with very high
degrees of anxiety, emotional insecurity, aggression, self-confidence, and ambition,
than employees possessing lower degrees of such traits (Porter and Steers,1973:151-
176).
Job related attitudes such as job involvement also affect turnover. Job involvement is
the degree to which a person identifies psychologically with his or her job and
considers his or her perceived performance level important to self worth. High levels
of job involvement have been associated with lower turnover rates (Blau and Boal,
1987:290).
The study of interrole conflict and its consequences has been one of the most common
areas of research on professional workers. The concept of interrole conflict arises
from incompatible role requirement between two or more work related roles.
Professionals belong to professional associations and they work according to the
expectations set by these associations concerning professional behaviour. This ensures
commitment to professional values and skills. Organisations also invoke minimal
expectations to ensure that tasks are completed in a prescribed manner in order for
members to receive compensation. The goals of the organisation, however, may
differ from those of the profession which results in interrole conflict. Interrole
conflict has been found to generate negative consequences, such as lower level of job
satisfaction as well as higher propensity to leave the organisation (Liu, Ngo and
Tsang, 2001:470-474).
According to Boles, Howard and Donofrio (2001:383) conflict between work and
family responsibilities can also have negative effects on an employee. Satisfaction
with work has been found to be lower among individuals who report conflict between
family duties and work responsibilities. An individual's job satisfaction is related to
their level of organisational commitment, which, in turn, is related to propensity to
leave. Therefore jobs that lead to work-family or family-work conflict (or both) are
41
more likely to expect an increase in propensity to leave and eventually turnover
among individuals occupying these positions.
Frequent and potentially lengthy separations from home and family are unfortunately
features of military life. Research has shown that family separation is considered an
important source of stress over and above the difficulties such as the threat of danger
and problems of the families left behind (Limbert, 2004:38). The results of a survey
carried out in the British Air Force showed that separation from family was the fourth
most influential reason for leaving the service. The British Military has also
recognised that it has problems recruiting and training personnel as the separation
from family and friends was an important factor preventing people from wanting to
belong to armed forces (Limbert, 2004:38).
Group demography can also assist in predicting turnover. Group demography is the
degree to which members of a group share a common demographic attribute, such as
age, gender, race and educational level, or length of service in the organisation and
the impact of this attribute on turnover. Groups and organisations are made up of
cohorts, which are defined as individuals who hold a common attribute. For instance
everybody born in 1960 is of the same age. Several studies have found turnover to be
higher among individuals that fall outside a cohort. Group demography therefore
suggests that such attributes as age or the date that someone joins an organisation
would enable one to predict turnover (Robbins, 1996:315-316 and McCain, O' Reilly,
andPfeffer, 1983:626-641).
The nature of organisational work environment, which includes both organisational
politics and organisational support, can also predict intention to leave the
organization. Organisational politics is perceived as a negative force contributing to
negative affective and behavioural outcomes (Ferris and Kacmar, 1992:94). To
explain it more simply, it is difficult for employees to react positively when they
perceive that promotions, pay raises and organisational rewards (among other things)
are based upon political considerations, rather than formal, objective considerations,
such as merit or output (Witt, Andrews and Kacmar, 2000:342). Organisational
support, on the other hand, is regarded as a global construct intended to measure
perceptions of support provided by the organisation, and these perceptions have been
42
found to be positively related to positive work outcomes (Rhoades and Eisenberger,
2002:698). Employees who perceive high levels of organisational support tend to
increase work effort, citizenship behaviours, and tenure (Cropanzano, Howes,
Grandey and Toth, 1997:159).
Studies on the age-turnover relationship have more often indicated that the older one
gets, the less likely they would be to quit. This is as a result of fewer alternative job
opportunities. Li addition, these employees are less likely to resign as their longer
tenure provides them with higher wage rates, longer paid vacations, and more
attractive pension benefits (Robbins, 1996:85).
An examination of tenure in negative work environment, (e.g. highly political
environments or environments with low organisational support), cause low tenure
individuals to start searching for employment elsewhere. The negative effect of these
environments suggests that the benefits accrued are not commensurate with the
personal investment made. This is deemed an inequitable situation by the individual
prompting them to leave the organisation. High tenure individuals on the other hand
tend to cope with operating in a negative environment. These individuals perceive
that regardless of the nature of the organisational environment, too much has been
invested in the organisation and that their losses will be greater if they chose to leave,
so they opt to remain in the organisation (Valle, Harris and Andrews, 2004:118).
2.5.4 REDUCING EMPLOYEE TURNOVER
The employee motivation theories discussed earlier offers an explanation of how
employee motivation affects employee retention and other behaviours within
organisations. Ramlall (2004:58-59) synthesized and critically analysed the employee
motivation theories and compiled the major factors from the respective theories and
explained how they could affect employee retention efforts.
• Needs of the employee - employees have various needs based on their
individual, family, and cultural values. In addition these needs are influenced
by the current and desired economic, political and social status, career
43
aspiration; the need to balance career, family, education, community, religion
and other factors; and a general feeling of one's satisfaction with the current
and desired state of being.
• Work environment - Employees prefer to work in an environment that is
productive, respectful, provides a feeling of inclusiveness, and offers friendly
setting.
• Responsibilities - Employees who can perform in a more challenging capacity
and has previously demonstrated such competencies, may feel a need seek
additional responsibilities and be rewarded in a fair an equitable manner.
• Supervision - Managers and other leaders often have a greater desire to teach,
coach and develop others. In addition these individuals also strive to influence
the organisations goals, objectives and strategies designed to achieve the
mission of the organisation.
• Fairness and equity - Employees expect to be rewarded in a fair an equitable
manner regardless of age, gender, ethnicity, disability, sexual orientation,
geographic location, or other similarly defined categories. Higher performing
employees expect better rewards than the average or below average employee.
• Effort- Employees find it difficult to exert higher levels of effort into a
position even when offered higher rewards especially if the task itself does not
challenge or provides satisfaction to the employee.
• Employees' Development - Employees thrive in environments that provide a
challenge, offer new learning opportunities, makes a valuable contribution to
an organisations success, offers opportunities for advancement and personal
development based on success and demonstrated interest in a particular area.
• Feedback - Timely and open feedback from supervisors is important to
employees. This feedback should be an ongoing process during the year and
44
not limited to formal performance reviews once or twice per year. In addition
the feedback should be from both the employee and supervisor.
According to Maertz and Campion (2004:566) a lot of research has been conducted
on turnover most of it has focused on the hows and whys of turnover but not both
simultaneously, except for (e.g.; Lee and Mitchell 1994) where there was some
inevitable overlap. The process models focus on how individuals arrive at their final
decisions to quit, while content models focus on why individuals quit organisations.
According to Maertz and Campion (2004:566) not much research has focused on
whether different motives systematically relate to different types of decision
processes. If research indicated that motives and processes were systematically
related, researchers could build 'motive by process' models that would provide more
precise and accurate descriptions of turnover. A study conducted by Maertz and
Campion (2004:566-582) integrated the process and content theory of turnover, by
proposing and testing the hypothesis that relate turnover motives to turnover decision
processes. Results have suggested that process-content integration is a fruitful
direction for turnover research.
2.5.5 Conclusion
The theories of job satisfaction also known as the theories of motivation, describes
two categories of theories namely the content and process theories. The content
theories identify the different needs important to individuals and the process theories
analyse how these needs lead the person to behave in a particular way relative to
available rewards and work opportunities. In context of the present study these
theories provide valuable knowledge that contributes to the understanding of the
major contributing factors that affect job satisfaction. The research on job satisfaction
across the different demographic variables also provides valuable information gained
from several studies and inferences can be made from these findings to explain the
results of the present study. Finally the research on job satisfaction and propensity to
leave, also highlight the predictors of turnover. These predictors of turnover can be
identified in the context of the present study and the necessary recommendations can
be made to reduce employee turnover in the SAMHS.
45
CHAPTER THREE
BACKGROUND TO THE ORGANISATION
3.1 OVERVIEW OF THE DEPARTMENT OF DEFENCE
Since the dawn of a new South Africa, the Department of Defence (DOD) has been
engaged in a transformation exercise guided by the principles of "Defence in a
Democracy". The aim of the transformation of the Department of Defence is its goal
of a non-racial, non-sexist and non-discriminatory institution whose composition shall
broadly reflect the demographics of the country. The mandate for DOD is enshrined
in the Constitution. The task of the DOD is to provide effective defence for a
democratic South Africa, enhancing national, regional and global security through
balanced, modern, affordable and technologically advanced defence capabilities. The
South African National Defence Force (SANDF) must defend and protect the
Republic of South Africa, its territorial integrity and its people in accordance with the
Constitution and the principles of international law regulating the use of force (DOD,
2003, paragraph v).
However, in times of peace, as at present, the SANDF performs many other secondary
tasks in support of Government's outcomes. With the ever-increasing role of South
Africa in regional conflict-resolution and peace-building efforts, there is a
corresponding increase in the need for the involvement of the SANDF in peace-
support operations. This does not only impact on the budgetary requirements of the
DOD, but also on the long-term operational planning for aspects such as recruitment,
equipment, facilities and the military strategy. Although the SANDF is involved in
peace-support operations, its main priority remains defending the country against
aggression. Despite the fact that the DOD is a contingency-based organisation and
does not render direct service to the public, it is critical that it functions in the most
economical, efficient and effective manner. Furthermore, given the budgetary
constraints, it is imperative that the DOD utilises all the resources at its disposal
productively. Thus, it has embarked on a restructuring exercise, which will result in
streamlined processes and measurable outputs (DOD, 2003, paragraph, vi).
46
3.1.1 HUMAN RESOURCE STRATEGY 2010
The aim of the DOD human resource (HR) strategy 2010 is to ensure that that the
right quantity and quality of human resources are available in the right places at the
right times, and that they are effectively, efficiently and economically managed and
administered. The strategic goals of the HR Strategy 2010 are indicated below (DOD,
2003, paragraph 48).
The strategic goals of the HR Strategy 2010 are to:
• Rejuvenate the SANDF's HR composition with young, fit and healthy
members, who fulfil the operational utilisation needs.
• Achieve an affordable HR composition
• Adequately resource and utilise the regular force and the reserve force.
• Replace the current SANDF service system with a new service system that
will reduce personnel expenditure and optimise force level flexibility.
• Attain a broad level of representivity at all levels and in all occupational
classes.
• Improve HR service delivery.
• Obtain equity in management and administration of uniformed and civilian
personnel
• Retain the required operational and functional expertise.
The transformation process resulted in changes to the human resource strategy, which
enabled the restructuring of each arm of service. The SAMHS being one of the four
arms of service embarked on the transformation and restructuring process.
3.2 OVERVIEW OF THE SAMHS
The South African Medical Service (SAMS) was established as a full service branch
of the South African Defence Force (SADF) in 1979 in order to consolidate the
medical services of the South African Army, Navy and Air Force. The South African
Medical Service (SAMS) was incorporated into the SANDF on 27 April 1994, and
47
was renamed the South African Military Health Service (SAMHS) on 1 June 1998
(DOD, 2001, online).
SAMHS is responsible for medical facilities and the training and deployment of all
medical personnel within the force. Though unusual, as most national militaries
integrate their medical structures into their existing service branches, the SANDF
regards this structure as being the most efficient method of providing care and support
to the SANDFs personnel (DOD, 2001, online).
The Surgeon General heads the SAMHS and has the rank of Lieutenant-General. The
SAMHS has three Military Hospitals, one in Pretoria, one in Cape Town and one in
Bloemfontein. There are also three specialised institutes - the Institute for Aviation
Medicine, the Institute for Maritime Medicine and the Military Psychological
Institute. Together, these units provide comprehensive medical care for military
personnel and their dependents. The Institute for Aviation Medicine and the Institute
for Maritime Medicine screen pilot candidates for the air force and for civilian
aviation certification, as well as divers and submariners for the navy. The military's
medical services also include general medical and dental care, and specialised
rehabilitation services (DOD, 2001, online).
The SAMHS is organised into regional medical commands, corresponding to the
army's regional commands, as well as a Medical Logistics Command and a Medical
Training Command. The regional commands support military units, military base
hospitals, and military unit sickbays in their region. The Medical Logistics Command
is responsible for medical logistics only, as each service provides for its own logistics
support (DOD, 2001, online).
3.2.1 MILITARY HEALTH CAPABILITES
The SAMHS provides military health support to deployed DOD members and
essential military health services to the SANDF, its members and their dependants
through it various military health capabilities (DOD, 2003, paragraph 29). The
military health capabilities of the SAMHS are as follows:
48
• Mobile Formation. Provide mobile military health support in a multi-
disciplinary military health combat-ready capacity (including specialised
functions for land, air, maritime and clinical evacuation support) and
equipment for operational utilisation at short notice, in accordance with the
DOD's force design and international obligations.
• Area Military Health Services. Provide a comprehensive, excellent, self-
supporting, multi-disciplinary area military health service through nine area
military health units to ensure a healthy military community.
• Specialist / Tertiary Health. Provide a specialist health service to ensure the
development, establishment and maintenance of tertiary military health
capabilities within the parameters of relevant legislation as contained in the
SAMHS strategy. This service includes hospital, aviation, maritime and
animal health specialties.
• Military Health Support Formation. Provide military health support,
pharmaceutical warehousing, sundries, SAMHS mobilization equipment and
unique stock, the procurement of SAMHS unique products, materials and
services, and providing logistic support.
• Base Support Capability. Provide general base support services to identified
units and other identified clients in order to sustain and maintain the approved
force design and structure.
• Military Health Training. Provide a Military Health Training Service to
ensure the development, establishment and maintenance of military health
training capabilities within the parameters of relevant legislation and policy.
3.2.2 AREA MILITARY HEALTH SERVICE KWAZULU-NATAL
The above overview does place the area military health services in context of the
overall military health capabilities of the SAMHS. It is important to understand that
healthcare professionals in the SAMHS are exposed to various different working
environments within the same organisation and therefore job satisfaction of healthcare
professionals may differ quite significantly depending on the units that they work at
and the services they render. As indicated there are nine military health units and
Area Military Health Unit (AMHU) KZN is one of these units.
49
As mentioned previously the role of the area military health unit is to provide a
comprehensive, excellent, self-supporting, multi-disciplinary military health service to
ensure a healthy military community. In AMHU KZN there is no military hospital
but there are three healthcare centers based in Durban, Matubatuba and Ladysmith.
The multi-disciplinary team in AMHU KZN consists of doctors, nurses, biokinetists,
dieticians, environmental health officers, dentists, oral hygjenists, social workers,
psychologists and pharmacists. All these disciplines are actively involved in the
overall formulation of policy, planning, management, control, organisation,
administration and co-ordination of their respective services rendered in AMHU
KZN.
The transformation and the restructuring of the SAMHS in line with the human
resource strategy of the DOD, has placed increased pressure on healthcare
professionals and the healthcare system in AMHU KZN. In addition the changing
face of the SANDF with the move to increased external peace- keeping and peace
supporting deployments has lead to a drastic shift in the once stable environment that
the healthcare professionals were exposed to. These are some of the challenges facing
health care professionals, which could affect their intention to remain in the military.
In terms of the organisation it is imperative that they do retain the professional staff as
this affects the combat readiness of the forces. In light of this it was decided to
conduct a study on the job satisfaction of healthcare professionals in AMHU KZN
with the specific objectives of the study being:
• To determine the major contributing factors that affect job satisfaction.
• To determine if there are differences in terms of job satisfaction among
health care professionals across the different demographic variables.
• To explore the correlation between job satisfaction and intention to leave.
50
CHAPTER FOUR
RESEARCH METHODOLOGY
4.0 INTRODUCTION
An integral part of optimising service delivery in SAMHS and putting the principles
of Batho Pele into practice is to ensure employee satisfaction among the healthcare
professionals. Spytak et al (1999:26) noted that satisfied employees tend to be more
productive, creative and committed to their jobs, and have shown a direct correlation
between employee satisfaction and customer satisfaction. Therefore this chapter
details the research undertaken to determine the level of job satisfaction of health care
professionals in AMHU KZN.
4.1 RESEARCH DESIGN
The following are the specific objectives of the study:
a) To determine the major contributing factors that affect job satisfaction.
b) To determine if there are differences in terms of job satisfaction among health
care professionals across the different demographic variables.
c) To explore the correlation between job satisfaction and intention to leave
In order to achieve the objectives a comparative cross-sectional study of health care
professionals at a single point in time in a military medical setting was conducted.
The research methodology adopted in this study was a quantitative survey. Cooper
and Schindler (2003:81) write that a survey/questionnaire design refers to a set of
questions designed to generate the data necessary for accomplishing the objectives of
the research project. A section on demographic data was included to determine if
there were differences in job satisfaction among health care professional across the
different demographic variables. In this study two highly structured questionnaires
were used to gather the data. These questionnaires included a job satisfaction
questionnaire and a propensity to leave questionnaire. The questionnaires were
utilised to ascertain the level of job satisfaction among health care professionals, and
51
to determine if there was any correlation between the levels of job satisfaction and the
intention to leave the military.
4.2 SAMPLE
The South African Military Health Services (SAMHS) has military medical facilities
in each province, which renders medical services to all South African National
Defence Force members, their dependants and approved clientele. The population
comprised of all health care professionals in the SAMHS, however, due to
geographical constraints the present study was limited to the KwaZulu-Natal region
and the sample was drawn form this region. Area Military Health Unit KwaZulu-
Natal (AMHU KZN) comprises various health care professionals, and these include
medical doctors, nurses, social workers, dieticians, biokinetists, pharmacists, dentists,
oral hygienists, dental technicians, psychologists, and occupational and environmental
health officers. These health care professionals are based at various medical facilities
and operational units throughout KwaZulu-Natal. It should be noted that Area
Military Health Unit KwaZulu-Natal does not have a military hospital. Health care
professionals are based in the main medical Health Service Centres in Durban,
Ladysmith and Matubatuba. The Ladysmith and Matubatuba Health Service Centres
have a centralised medical facility. However, the Durban Health Service Centre is
made up of decentralised medical facilities. This includes four sickbays that are
situated at the Bluff, Durban Central, Isipingo and Pietermaritzburg. Also included as
part of Durban Health Service Centre are the Environmental Health Department, the
Occupational Health Department and the Dental Department that occupy separate
facilities in Durban and are not a part of the sickbay structure.
All managers of the various health care professionals are based at the Bluff
headquarters in Durban. In order to determine the exact number of health care
Professional in Area Military Health Unit KwaZulu-Natal a list of all members in the
employ of Area Military Health Unit KwaZulu-Natal and their relevant health care
occupations was obtained from the Human Resources Department. In total, there are
87 health care professionals. For the purpose of this study a 100% sample size was
chosen due to the small population sample on hand. However, not all the health care
professionals were available as some members were on course, or on external
52
deployment and on leave and therefore only 72 health care professionals were
available to participate in the study. The sample included both the managers and the
subordinates.
Due to restrictions placed by the South African Military Health Services ethics
committee the sample could not be categorised according to professional groupings
(e.g. doctors, nurses, social workers) or Health Service Centres. Out of the potential
total sample of 72 health care professionals, 3 candidates declined to participate and 8
questionnaires had to be excluded from the study, as they were incomplete. This
resulted in a completed sample of 61 questionnaires, which is equivalent to a response
rate of 86%.
4.3 RESEARCH INSTRUMENT
A survey questionnaire (Appendix A) was used to collect data from the respondents.
The questionnaire consisted of a demographic questionnaire and two established and
existing scales, namely the Job Satisfaction scale (Van Breda, 2003) and the
Propensity to Leave scale (Lyons, 1971 cited in Stroud, 2003:63).
4.3.1 DEMOGRAPHIC QUESTIONNAIRE
The demographic questionnaire was used to obtain information on age, gender,
tenure, marital status and number of children. This information was used to
determine the level of job satisfaction among health care professionals across the
different demographic variables. Due to restrictions placed by the South African
Military Health Service Ethics Committee, demographic factors such as race, rank,
previous force, unit, and occupation could not be included.
4.3.2 JOB SATISFACTION QUESTIONNAIRE
There are many standardised job satisfaction scales available. However, the researcher
obtained permission to use a job satisfaction questionnaire, developed by the Military
Psychological Research Institute in the South African Military Health Services, as it
was applicable to the military environment. The questionnaire included a Likert scale
53
where ratings were graded into: Strongly Disagree, Disagree, Uncertain, Agree,
Strongly Agree. The job satisfaction questionnaire contained 63 statements
(Appendix B) and this instrument was subjected to a series of statistical analyses with
the aim of reducing the 63 items to a smaller number of constructs. Based on
confirmatory factor analysis the original 63 questions were reduced to fifteen
constructs. These constructs were: strategic direction, strategic support, equal
opportunity, career security, resources, the environment, inter- departmental,
cohesion, management, work itself, retention, enrichment, extension, and value
adding. The alpha coefficients ranged from .69 to .92 with fourteen of the constructs
having alphas of .70 or above. The standard errors of measurement ranged from 4.5 to
13.7 with nine of the constructs having standard errors of measurement of 10 or less.
The coefficient of construct validity ranged from .53 to .86 and the mean inter item
correlations ranged form .39 to .86 with fourteen scales having mean interim
correlations of .40 or above. The discriminant validity coefficients were also
measured and with values ranging from .15 to .33. Thirteen of the scales had
discriminant validity coefficients of .30 or below. Based on these results thel5
constructs were found to have good measurement properties (Van Breda, 2003:5-7).
This instrument therefore seemed most suitable to be used in the current study
However, the original job satisfaction questionnaire was administered specifically to
members of the Military Psychological Institute (Van Breda, 2003). This unit is a
specialised research unit that is completely independent of other medical units and is
under the direct command and control of the Directorate Psychology. The Directorate
Psychology has the authority to make decisions with regard to the future of the unit
and has complete administrative and functional control over the unit. However, at
Area Military Health Units level, the directorate of each health care professional is
responsible for providing strategic direction to their staff, but they have no authority
over the administrative control and future of the unit. All administrative decisions
with regard to health care professionals are made independently of the directorates.
In light of this it was decided that some of the questions on the job satisfaction scale
needed to be changed as it was not applicable to the context of the present study.
Some questions were also amended to ensure that there was no ambiguity and that
54
more specific and relevant information with regard to the study population and the
unit concerned would be extracted.
Items on the scale were therefore adapted or changed as follows:
Table 4.1: Face Validity of Job Satisfaction Questionnaire
No Original Item (as
per Appendix B)
Amended Item (as per
Appendix A)
Reason for Amendment
1 Item 9 Enough is being
done to resolve
resource problems
Item 6 There is too much
red tape in resolving
resource problems
It did not address the core
problem with regard to
resources.
2 Item 11 The physical
surroundings have an
effect on my work
satisfaction
Item 8 It is difficult to
render a professional
service in my present
physical surroundings.
The original statement is
ambiguous.
3 Item 13 My directorate
cares about the future
of my unit
Item 17 My directorate is
pro active and can make
things happen.
The medical units are not under
the direct control of the
directorates therefore this
question would not be
applicable and the revised
question would be most
appropriate.
4 Item 16 It is unclear
how my profession fits
into the DOD as a
whole
Item 5 I have confidence
and respect for my
directorate.
This question was applicable to
MPI, as a specialised unit, it is
not applicable to the healthcare
professionals as they are the
core function of the SAMHS.
5 Item 23 Promotions are
done promptly
Item 21 Promotions for
professionals are few and
far between
The original statement is
misleading as it could refer to
both military personnel and
healthcare professionals in
AMHUKZN.
55
No Original Item (as
per Appendix B)
Amended Item (as per
Appendix A)
Reason for Amendment
6 Item 25 Promotions are
made possible for a
certain group of people
and not for others
Item 41 Not everyone has
the same promotional
opportunities.
The statement is vague and
could have varied
interpretations.
7 Item 32 I get positive
feedback about my
work from my seniors
Item 29 I receive
recognition for a job well
done from my seniors.
The word "work" is too broad,
the statement was changed to be
specific and applicable.
8 Item 41 Deadlines set
for projects are
unrealistic
Item 12 Most of the time
my workload is manageable
The word "project" was
applicable to MPI and is not
applicable to the services
rendered by the healthcare
professions.
9 Item 48 Unit outings
are a waste of time
Item 44 Planned social
events improve cohesion
among health care workers
Rephrased to specifically
address the issue of cohesion.
10 Item 51 The staffing
procedures in this
organization are
confusing
Item 15 The staffing
process in this unit is
unclear
The amended statement
provides better clarity.
11 Item 60 The work I do
is important to me
personally
Item 56 I get personal
satisfaction from the work I
do.
The statement was rephrased
for better comprehension.
12 Item 69 I feel
demoralized
Item 35 My level of morale
is high
This statement was highly
negative.
13 Item 50 There are
staffing problems
Item 16 There are
opportunities for my
growth and development in
this unit
Staffing problems is a more
generalized statement
especially at Area Military
Health Unit level where it could
be applicable to both military
personnel and healthcare
professionals.
56
No Original Item (as
per Appendix B)
Amended Item (as per
Appendix A)
Reason for Amendment
14 Item 311 get positive
feedback about my
work from my peers
Item 28 My immediate
supervisor is willing to
listen and assist when I
have questions and
problems
MPI has peers, this is not the
situation with each healthcare
professional at the Area
Military Health Unit.
15 Item 66 I get personal
rewards from the work
I do
Item 67 My job makes full
use of my skill and abilities.
This question was similar to
item 60 (Appendix B) " the
work I do is important to me
personally"
16 Item 33 My peers
motivate me in my
work
Item 66 The management
ofAMHUKZN
administers rules and
discipline consistently.
The statement is not applicable
to all the healthcare
professionals.
17 Item 70 MPI has a
bright future
Item omitted Not applicable to Area Military
Health Units.
A number of significant changes were made to the original job satisfaction
questionnaire by the current researcher as indicated in Table 3.1. As a result of the
changes a complete psychometric analyses of the revised job satisfaction
questionnaire was completed and the co-efficient alpha was re-calculated.
4.3.3 PROPENSITY TO LEAVE SCALE
The Propensity to Leave questionnaire was made up of 4 questions, the first 2
questions had ratings that were graded into: Not at all likely, Some What likely,
Quite likely and Extremely likely. The last 2 questions had ratings that were graded
into a 7 point scale: Strongly Disagree, Disagree, Slightly Disagree, Neither Agree
nor Disagree, Slightly Agree, Agree and Strongly Agree. The test has been used
successfully in South African studies with internal reliabilities ranging from 0.79
(Bluen , 1986 cited in Stroud, 2001:63) to 0.82 (Sergay, 1990 cited in Stroud, 200:63).
57
4.4 PROCEDURE
After approval of the research from the SAMHS ethics committee and the UKZN
ethics committee, the researcher obtained permission from the Officer Commanding
of AMHU KZN to administer the survey to all health care professionals. The
questionnaires were self-administered at all the sickbays and medical units that were
part of the Durban Health Service Centre. At the Matubatuba and Ladysmith Health
Service Centre the officer in charge of the medical unit administered the
questionnaires. These officers were given specific instructions on how to administer
and collect the questionnaires, ensuring confidentiality, anonymity and voluntary
participation. The participants were instructed to complete the questionnaires and
place the unmarked, sealed envelopes in a box. The questionnaires were administered
over a two -week period. Individuals who were unable to complete the questionnaire
during this period were excluded from the study. A total of 72 questionnaires were
administered.
4.5 TIME FRAME
The data was collected from 17 April to 28 April 2006.
4.6 ETHICAL CONSIDERATIONS
All research conducted in the SAMHS has to meet with the approval of the SAMHS
ethics committee. A detailed application for the said research was submitted to the
SAMHS ethics committee and was approved. Each stage of the research had to be
submitted to Defence Intelligence to ensure that no data of a sensitive nature would be
disclosed to any unauthorised external source. In addition, application was also made
to the UKZN ethics committee for approval (see Appendix D). In conducting this
research the following issues were highlighted by the ethics committee, as areas were
ethical matters could arise:
• The researcher had to ensure that anonymity; confidentiality and voluntary
consent were upheld at all times. A covering letter to the questionnaire
detailing this information had to be included (see appendix A).
58
• The researcher had to ensure that the research would not be of any cost to the
SAMHS in terms of transport and resources required.
• Research had to be conducted with minimal disruption to service delivery.
• All questionnaires received had to be stored and disposed off in accordance to
the guidelines of Defence Intelligence
• Demographic data that could not be obtained due to restrictions by the
SAMHS ethics committee included language, rank, previous force, and
occupation.
4.7 ASSUMPTIONS
The main assumption was that all respondents were honest in their responses.
4.8 DATA ANALYSIS
The data analysis was quantitative. The analyses were conducted as per objective of
the study namely:
• Objectivel: To determine the major contributing factors affecting job satisfaction.
Descriptive Scale Scores were compiled for each item on the job satisfaction
questionnaire. Factor analysis was then used as a data reduction technique to
reduce the large number items to a smaller set of underlying factors that
summarise the major contributing factors affecting job satisfaction.
• Objective 2: To determine if there were differences in job satisfaction among
health care professionals across the different demographic variables. ANOVAs
were carried out to determine the effect of job satisfaction across the different
demographic variables.
• Objective 3: To explore the correlation between job satisfaction and propensity to
leave. The Pearson's Correlation was used to test the relationship between job
satisfaction and propensity to leave.
59
CHAPTER FIVE
RESULTS
5. INTRODUCTION
The sample consisted of 61 respondents who completed the questionnaires. The
researcher coded all the data and captured it onto a spreadsheet. Reverse scoring was
done for the relevant items. Accuracy of the data was facilitated by an examination of
frequency tables after capturing. Thereafter the relevant statistical analyses were
conducted in relation to the objectives of the study. The statistical analysis of the raw
data included, ANOVA's, Pearson's Correlations, and Factor Analysis. The reliability
and validity of the measuring instruments will be reported on together with the results
directly related to the objectives of the study. The objectives of the study were as
follows:
• To determine the major contributing factors that affect job satisfaction
• To determine if there are differences in terms of job satisfaction among health
care professionals across the different demographic variables.
• To explore the correlation between job satisfaction and propensity to leave.
60
5.1 DESCRIPTION OF SAMPLE
The final sample consisted of 61 respondents.
5.1.1 GENDER
Table 5.1 Breakdown of sample by gender
Frequency Percent Valid Males
22 36.1 Valid
Females 39 63.9
Valid
Total 61 100.0
From these results it is evident that the majority of health care professionals 63.9%
are female and only 36.1% are male.
5.1.2 AGE
Table 5.2 Breakdown of sample by age
Frequency Percent Valid 20-29yrs 14
23.0 Valid
30-39yrs 25
41.0
Valid
40-49yrs 16 26.2
Valid
50-59yrs 6 9.8
Valid
Total 61 100.0
From these results, the vast majority of health care professionals 64% are below the
age of 40. 26.2% of the respondents are in their forties and 9.8% in their fifties. 41%
of the respondents are in their thirties and only 23% of the respondents are in their
twenties.
61
5.1.3 TENURE
Table 5.3 Breakdown of sample by tenure
Frequency Percent Valid < lyr 4
6.6 Valid
l-5yrs 21 34.4
Valid
6-10yrs 9 14.8
Valid
10-15yrs 22 36.1
Valid
+ 15yrs 5 8.2
Valid
Total 61 100.0
There is a widespread distribution in the number of years of military experience
shared by respondents who participated in this study. The largest group of
respondents 36.1% had 10-15 years of military experience; the second largest group
of respondents 34.4% had 1-5 years of experience. Only 8.2% of the respondents
were long serving members with more than 15 years of military experience. Over
half of the unit 55.8% had less than 10 years of military experience and of this only
6.6% had less than 1-year military experience (this includes health care interns).
5.1.4 MARITAL STATUS
Table 5.4 Breakdown of sample by marital status
Frequency Percent Valid Married 39
63.9 Valid
Divorced 2
3.3
Valid
Single 20 32.8
Valid
Total 61 100.0
The vast majority of the respondents are married 63.9%. Only 3.3% of the
respondents were divorced and 32.8% of the respondents were single
62
5.1.5 CHILDREN
Table 5.5 Breakdown of sample based on whether respondents had children.
Frequency Percent Valid Yes 43
70.5 Valid
No 18 29.5
Valid
Total 61 100.0
From the results above it is evident that the majority of the respondents do have
children 70.5 %.
The SAMHS ethics committee restricted the collection of demographic data on the
military ranks of respondents, race, professional occupations, the previous force that
the member belonged to before transformation, and the Health Service Center that the
member was based at. These restrictions lead to limitations in the researcher's ability
to describe the sample fully.
5.2 RELIABILITY OF MEASURING INSTRUMENTS
Cronbach alphas were computed to determine the internal reliability of the measuring
instruments.
a. A reliability analysis was carried out on the items 1 to 63 of the job
satisfaction scale and the results yielded a Cronbach alpha of .94.
b. The propensity to leave scale comprised 4 questions (Appendix A, Section C).
The first two items (Section C, 1-2) had a 4-point rating scale while the last two items
(Section C, 3-4) had a 7-point rating scale. Therefore, when determining the Cronbach
alpha it was important to look at the Cronbach alpha of each of these two sections
separately before determining the overall Cronbach alpha. The results yielded a
Cronbach alpha of .69 for (Section C, 1-2) and a Cronbach alpha of .91 for (Section
C, 3-4). The overall Cronbach alpha of the propensity to leave scale was .79.
63
5.3 OBJECTIVE 1: TO DETERMINE THE MAJOR CONTRIBUTING
FACTORS AFFECTING JOB SATISFACTION
The first objective of the study was to determine the major contributing factors that
affect job satisfaction. Appendix C consists of an item analysis, providing the
frequency and percentage of response to each of the 63 items in the measuring
instrument. The job satisfaction scale was a large scale consisting of 63 items
(variables) that were designed to measure the construct job satisfaction. Since the
number of simple correlations among the variables is very large it would be difficult
to summarise by inspection what the patterns of correlations represents. Therefore, it
is important to reduce a large number of variables to a smaller set of underlying
factors that summarise the essential information contained in the variables.
The Principal Components Analysis (using varimax rotation) approach was used in
this study. This method of analysis is used to transform the original variables into
underlying components (principal components) that would account for most of the
variance on the scale (Stevens, 1986: 340).
5.3.1 PRINCIPAL COMPONENT ANLAYSIS
a. Table 5.6 below indicates the variation of the main components of the job
satisfaction scale.
Table 5.6: Total Variance of Main Components
Component Initial Eigenvalues
Component Total % of Variance Cumulative % 1 14.92 23.69 23.69 2 5.15 8.18 31.87 3 3.90 6.19 38.07 4 3.32 5.26 4333 5 3.16 5.02 48.35
Extraction Method: Principal Component Analysis.
64
b. One of the criteria for deciding on how many components to retain, is to retain
components whose eigen values are greater than 1. However according to Stevens
(1986:341), the blind use of this rule could lead to retaining factors, which may have
no practical significance (in terms of the percentage of variance accounted for).
Morrison (1967) cited in Stevens (1986:342) found that in some cases it was better to
summarise the complex in terms of the first few components which account for large
and distinct amounts of variance. This method allows for more of the total
information in the complex to be retained although some parsimony is sacrificed.
c. Based on the above explanation, the first 5 components that accounted for the
largest and most distinct amount of variation was selected. The first component
accounted for 23.69 % of the variance, the second component 8.18%, the third
component, 6.19%, the fourth component, 5.26% and the fifth component 5.02%.
The cumulative variance that the 5 components explained was 48.35%.
d. The rotated component matrix was used to find out which items had to be
discarded. According to Stevens (1986:344) factor loading of 0.3 or greater can be
considered to be significant. However, it is important that the sample size be looked at
in determining which loadings are large enough to be practically significant.
e. Given the large number of items in the scale, and the small sample size of 61
(which is a limitation in this study as a sample size of at least a 100 respondents is
ideal), a factor loading of 0.4 or higher had to be used to ensure a reduction in the
number of items in the data set to a comprehensible set of items. The items with
loadings less than 0.4 that could hence be eliminated were items 3,22,24,30,48,61.
Factor analysis was re-run on the reduced data set and the number of components was
reduced to 4.
f. The rotated component matrix using Varimax with Kaiser Normalisation was
used to identify the items that made up each component/factor. The items making up
each of the 4 components are indicated below:
65
Table 5.7: Component 1
ITEM NO
ITEM
12 Most of the time my workload is manageable. 15 The staffing process in this unit is fair 18 I am satisfied with my salary 21 Promotions for professionals are few and far between 23 It is not clear which criteria are used to promote people. 24 There are equal opportunities for everyone. 29 I receive recognition for a job well done from my seniors. 31 I like the management style at my unit 35 My level of morale is high 37 The management of AMHU KZN administers policies fairly 38 I am proud to work at AMHU KZN 40 I am looking for another job. 41 Not everyone has the same promotional opportunities. 43 I have control over my career in the military 46 My seniors motivate me in my work. 47 The staffing process is this unit is unclear 48 I have job security 49 My future in this organization is unclear 52 An effort is put into career planning 53 I receive career guidance
The twenty items identified in this component tend to relate to the following themes:
a. Staffing and promotions 30%. This included (items 15,21,23,24,41,
47).
b. Career security, future, planning and guidance 30%. This included
(items 40, 43, 48,49, 52, 53).
c. Management style 20%. This included (items 29, 31, 37, 46).
d. Salary, workload and morale 20%. This included (items 12, 18, 35,
38).
From the above themes it would seem that most of the factors (80%) tend to relate
issues surrounding careers. This includes issues around career security, planning and
future, the issue of staffing and promotions of professionals in the military, and
recognition in terms of feedback, motivation from managers. Therefore this
component was labelled, 'Career Management'.
66
Table 5.8 Component 2
ITEM NO
ITEM
4 My organization provides the resources and tools that I need to do my job 14 My Directorate supports me when others challenge my work. 9 My salary compares with the output I deliver 10 My Directorate promotes my profession. 17 My Directorate is proactive an can make things happen 20 There is group cohesion among all health care professionals in AMHU KZN. 5 I am confidence and respect for my Directorate
28 My immediate supervisor is willing to listen and assist when I have questions and problems
30 There are clear policies set by my Directorate. 36 I am treated as a professional. 7 The benefits package we receive is as good as most other organizations
45 There are clear guidelines set by my Directorate 59 My Directorate fights for the interest of my profession
The thirteen items identified in this component tend to relate to the following themes:
a. Strategic direction and support 85%. This includes (items 4, 14, 10,
17, 5, 20, 28, 30, 36, 45, 59).
b. Satisfaction with salary and benefits 15%. This includes (items 9, 7).
The majority of these factors relate to strategic direction and support. This includes
the last two factors concerning salary and benefits as the Directorates at the strategic
level of the organisation have a direct input into the salary structures and benefits of
health care professionals. Therefore, this component was labelled as 'Strategic
Management and Support'.
Table 5.9 Component 3
ITEM NO
ITEM
32 I like the work I do. 57 The impact of my work is clear. 58 My work makes a difference in the DOD. 60 I enjoy taking on new responsibilities in my work. 61 I enjoy thinking of ways to improve the work I do. 56 I get personal satisfaction from the job I do 64 My job is interesting to me 67 My job makes full use of my skills and abilities.
67
The eight items identified in this component tend to relate to the following theme:
a. Satisfaction with the nature of the work itself 100%
All of the factors in this component relate to an individuals satisfaction with the work
itself. This component was labelled as 'Nature of Work Itself.
Table 5.10: Component 4
ITEM NO
ITEM
22 There is co-operation among the various departments in each Health centre 34 The merit assessment process is fair. 39 There is co-operation among the various health care professions across the
different health-service centres in AMHU KZN. 42 There is group cohesion in our health services centre 50 Opportunities are not provided for my professional development 54 The management of AMHU KZN is focused on the needs of the individual 63 There is communication among the various health care professions across
the different health services centres in AMHU KZN. 66 The management of AMHU KZN administers rules and discipline
consistently.
The eight items identified in this component tend to relate to the following themes:
a. Co-operation, communication and cohesion 50%. This includes (items,
22, 39, 42,63).
b. Management style concerning rules, discipline, and control 25%. These
include (items 54 and 66).
c. Other issues relate to fair administrative processes, professional
development 25%. This includes items (34 and 50).
The majority of the items in this component 75% tend to relate to member interaction,
team building, unit cohesion and management style with the emphasis on people
management, which focuses on the needs of the individual and fairness. All these
variables relate to interpersonal dynamics within the unit. Therefore this component
was labelled, 'Interpersonal Dynamics'.
68
5.3.2 MAJORITY ENDORSEMNET
Each of the four components identified above namely, career management, strategic
management and support, nature of the work itself and interpersonal dynamics, were
comprised of a large number of items. As a result it was necessary to look at an
additional analysis of the data in order to highlight the important items. Therefore
items with majority endorsement (endorsement by 50% or more of the respondents) in
each component were identified. A review of the table in Appendix C, indicates the
items with majority endorsement on the job satisfaction scale. Only the items with
majority endorsement in each component are indicated below:
5.3.2.1 Career Management
a. Negatively endorsed items: Seven items (35%) were negatively endorsed by
50% or more of the respondents (items 15, 18,24, 31, 43, 52, and 53).
These items include:
The staffing process is fair
I am satisfied with my salary
There are equal opportunities for everybody
I like the management style at my unit
I have control over my career in the military
An effort is put into career planning.
I receive career planning.
b. Positively endorsed items: Seven items (35%) were positively endorsed by
50% or more of the respondents (items 12, 21, 23, 38, 41, 47 and 49).
These items include:
Most of the time my workload is manageable.
Promotions for professionals are few and far between
It is not clear which criteria are used to promote people
I am proud to work at AMHU KZN.
Not everyone has the same promotional opportunities.
The staffing process in this unit is unclear.
My future in this organisation is unclear.
a. Item 15:
b. Item 18:
c. Item 24:
d. Item 31:
e. Item 43:
f Item 52:
8- Item 53:
a. Item 12:
b. Item 21:
c. Item 23:
d. Item 38:
e. Item 41:
f. Item 47:
8- Item 49:
69
5.3.2.2 Strategic Management and Support
a. Negatively endorsed items: Three items 23% were negatively endorsed by
50% or more or the respondents (items 4,9, and 17).
These items include:
a. Item 4: My organisation provides the resources and tools
that I need to do my job.
b. Item 9: My salary compares with the output I deliver.
c. Item 17: My directorate is pro-active and can make things
happen.
b. Positively endorsed items: Two items (15%) were positively endorsed by
50% or more of the respondents (items 5 and 28).
These items include:
a. Item 5: I have confidence and respect for my directorate.
b. Item 28: My immediate supervisor is willing to listen and
assist when I have questions or problems.
5.3.2.3 Nature of the Work Itself
a. Positively endorsed items: Eight items (100%) were positively endorsed by
50% or more of the respondents (items 32, 57, 58, 60, 61, 56, 64 and 67).
These items include.
I like the work I do
The impact of my work is clear
My work makes a difference in the DOD
I enjoy taking on new responsibilities in my work
I enjoy thinking of ways to improve the work I do
I get personal satisfaction from the job I do
My job is interesting to me
My job makes full use of my skills and abilities
a. Item 32
b. Item 56
c. Item 57
d. Item 58
e. Item 60
f. Item 61
g- Item 64
h. Item 67
70
5.3.2.4 Interpersonal Dynamics
a. Negatively endorsed items: Two items (25%) were negatively endorsed by
50% or more or the respondents (items 34 and 54).
These items include:
a. Item 34: The merit assessment process is fair
b. Item 54: The management of AMHU KZN is focused on the
needs of the individual.
5.3.3 SUMMARY
It should be noted that factor analysis was used in this analyses for 2 reasons:
a. to review the underlying psychometric properties of the original job
satisfaction scale, given the numerous changes made to the scale.
b. the job satisfaction scale was a very long scale with 63 items, therefore
it was important to reduce the large number of variables to a smaller
set of underlying factors that summarised the essential information
contained in the variables. This would have therefore enabled the
researcher to identify the major contributing factors affecting job
satisfaction in relation to objective one of the study.
In relation to objective one, the major contributing factors that affect job satisfaction
are:
a. Career Management
b. Strategic Management and Support
c. The Nature of the Work Itself
d. Interpersonal Dynamics
71
5.4 OBJECTIVE 2: TO DETERMINE IF THERE ARE DIFFERENCES IN
JOB SATISFACTION ACROSS THE DEMOGRAPHIC VARIABLES
The second objective of this study was to determine if there are differences in job
satisfaction among health care professionals across the different demographic
variables.
The demographic profile of the sample was determined and one-way analysis of
variance was carried out with the total job satisfaction score (average of the 63 items
on the job satisfaction scale) being the dependant variable. The results per
demographic variable are as follows:
5.4.1 GENDER
The results of the ANOVA for gender and total job satisfaction are indicated in table
5.11 below:
Table 5.11: ANOVA: Gender
JOBSATAV Sum of Squares df Mean Square F Sig (P)
Between Groups
.41 1 .41 .43 .51
Within Groups
56.44 59 .95
Total 56.85 60
According to the results above, at the (5%) significance level, the p-value of .51 is
much greater than 0.05, which shows that there are no differences between males and
females mean scores with respect to job satisfaction.
72
Figure 5.1: Means Plot: Gender
males females
GENDER
The means plot confirms the above conclusion as the graph indicates that the means
of the variables differ numerically from one another as the line joining the means is
not a constant one.
5.4.2 AGE
The results of the ANOVA for age and total job satisfaction are indicated in table 5.12
below:
Table 5.12: ANOVA: Age
JOBSATAV
Sum of Squares df Mean Square F Sig.(P) Between Groups
1.52 3 .50 .52 .66
Within Groups
55.33 57 .97
Total 56.85 60
According to the results above, at the (5%) significance level, the p-value of .66 is
much greater than 0.05 which shows that that there no are differences between the age
group mean scores with respect to job satisfaction.
73
Figure 5.2: Means Plot: Age
3.3
3.2
3.1
3.0
t 2.9
"5 2 8
2.7 20-29yrs 30-39yrs 40-49yrs 50-59yrs
AGE
The means plot confirms the above conclusion as the means of each of the variables is
different and the means plot depicts an irregular graph. The graph indicates that the
variables differ numerically from each other, as the line joining the means is not a
constant one.
5.4.3 TENURE
The results of the ANOVA for tenure and total job satisfaction are indicated in table
5.13 below:
Table 5.13: ANOVA: Tenure
JOBSATAV
Sum of Squares df Mean Square F Sig. (P) Between Groups
1.25 4 .31 .31 .87
Within Groups
55.60 56 .99
Total 56.85 60
According to the results above, at the (5%) significance level, the p-value of .87 is
much greater than 0.05, which shows that there is no differences between the tenure
groups mean scores with respect to job satisfaction.
74
Figure 5.3: Means Plot: Tenure
3 3
+15 yrs
The means plot confirms the above conclusion as the means of each of the variables
differ numerically and the means plot depicts an irregular graph.
5.4.4 MARITAL STATUS
The results of the ANOVA for marital status and total job satisfaction are indicated in
table 5.14 below:
Table 5.14: ANOVA: Marital Status
JOBSATAV
Sum of Squares df Mean Square F Sig.(P) Between Groups
.18 2 .09 .09 .91
Within Groups
56.67 58 .98
Total 56.85 60
According to the results above, at the (5%) significance level, the p-value of .91 is
much greater than 0.05 which shows that there are no differences between the marital
status groups mean scores with respect to job satisfaction.
75
Figure 5.4: Means Plot: Marital Status
3.08
1 3.02 .
3.00
15 2.98
2.96 married
MARITAL
single
The means plot confirms the above conclusion as the means of each of the variables
are different and the means plot depicts an irregular graph. The graph indicates that
the variables differ numerically from each other, as the line joining the means is not a
constant one.
5.4.5 CHILDREN
The results of the ANOVA for employees with or without children and total job
satisfaction are indicated in table 5.15 below:
Table 5.15:
JOBSATAV
ANOVA: Children
Sum of Squares Df Mean Square F Sig(P) Between Groups
2.29 1 2.29 2.47 .12
Within Groups
54.57 59 .93
Total 56.85 60
According to the results above, at the (5%) significance level, the p-value of. 12 is
much greater than 0.05, which shows that there are no differences between the child
status groups mean scores with respect to job satisfaction.
76
Figure 5.5: Means Plot: Children
yes no
CHILDREN
The means plot confirms the above conclusion as the means of each of the variables
differ numerically from each other as the line joining the means is not a constant one.
5.4.6 SUMMARY
The second objective of the study was to determine if there were differences in job
satisfaction across the different demographic variables, this included gender, age,
tenure, marital status and employees with and without children. The results indicated
that there were no differences in job satisfaction across the different demographic
variables such as gender, marital status, age, tenure and respondents with or without
children.
77
5.5 OBJECTIVE 3: TO EXPLORE THE CORRELATION BETWEEN JOB
SATISFACTION AND INTENTION TO LEAVE
Objective three was to explore the correlation between job satisfaction levels and
intention to leave.
Pearson's correlations were used to determine if there was a relationship between total
job satisfaction and propensity to leave and the four separate components of job
satisfaction and propensity to leave. The results are indicated in the table 5.16 below:
Table 5.16: Pearson Correlation: Job Satisfaction and Propensity to Leave
PROPENSITY TO LEAVE Total Job Satisfaction -.68 (**) Career Management -.57 (**)
Strategic Management and Support -.38 (**) Nature of Work Itself -.39 (**)
Interpersonal Dynamics -.36 (**)
** Correlation is significant at the 0.01 level (2-tailed).
There is a strong relationship between total job satisfaction and propensity to leave.
This relationship is an inverse one so we may conclude that as job satisfaction
increases the propensity to leave decreases. A strong inverse relationship also exists
between each component of job satisfaction, namely career management, strategic
management, nature of the work itself, interpersonal dynamics and propensity to
leave. This would imply that as the levels of job satisfaction of each of these
components increases the propensity to leave decreases and vice versa.
5.5.1 SUMMARY
The findings in this section identified four major contributing factors that do have an
effect on the level of job satisfaction among health care professionals and these
include career management, strategic management, the nature of the work itself and
interpersonal dynamics. There was also a strong correlation between each of these
components of job satisfaction and propensity to leave. A strong correlation was also
found between the total measure of job satisfaction and propensity to leave. This
78
meant that high levels of job satisfaction would result in a decreased propensity to
leave among health care professionals. Interestingly there was no difference noted in
job satisfaction across the demographic variables, namely gender, age, marital status,
tenure and children.
79
CHAPTER SIX
DISCUSSION
6.0 INTRODUCTION
The South African Military Health Services (SAMHS) as a military health service
provider is committed to optimising service delivery in order to improve the levels of
satisfaction among its clientele. An integral part of enhancing service delivery is to
ensure employee satisfaction among health care professionals. According to Schenke
(2001:8) there is a direct correlation between employee satisfaction and customer
satisfaction. In light of this a study was undertaken in AMHU KZN to determine the
major contributing factors that affect job satisfaction. The correlation between job
satisfaction and propensity to leave was also determined as a high turnover among
health care professionals has the potential to impact negatively on service delivery.
The study sample included 61 health care professionals based at Area Military Health
Unit KwaZulu- Natal (AMHU KZN). AMHU KZN will also be referred to as a
military medical unit in the discussions.
The demographics related to this sample will first be discussed and the subsequent
discussions in this chapter will follow the format of the research objectives and will
relate back to the literature.
6.1 DEMOGRAPHIC DISTRIBUTION OF THE SAMPLE
6.1.1 Age
Age distribution ranged from 20 to 59 years. Sixty four percent of respondents were
below 40 years old. Twenty six percent of the respondents were in the 40 to 49 year
age category. There was a sharp decline in the numbers of respondents in the 50 to 59
years age category, which accounted for only 10% of the respondents. There could be
a few possible explanations for the large percentage of respondents that fall below 40
years old. Firstly the South African Military Health Services (SAMHS) does provide
80
internship programmes for new graduates in the various health care professions, and
often these graduates on completion of their internship, apply for permanent posts in
the military medical services. The new graduates view this as an opportunity to
secure an income whilst deciding on their future career paths and better job prospects.
Secondly, the South African National Defence Force (SANDF) has a new recruiting
policy in place with the aim of maintaining a younger Defence Force. This policy
offers only short term (2 year) to medium term (10 year) contracts to health care
professionals, which may or may not be renewed depending on the need for services.
Thirdly, the military health service has a military skills development programme
(MSD) in place that offers study bursaries to school leavers. These individuals
usually have a contractual service obligation to the military upon completion of their
studies.
6.1.2 Gender
The gender distribution was predominantly female 64%, with males making up the
balance 36%. This could possibly be due to the fact that certain professions are still
female dominated, like nursing, social work and dietetics. The unit also has the
highest ratio of nurses, which is a female dominated profession, in comparison to the
other health care professionals. Another reason for the higher representation of
females compared to males is possibly due to the military maintaining a supportive
environment with the focus on healthy military families. As a result of this women in
professional positions are still able to assume the primary responsibility of child and
home care. According to the gender role theory, women are more likely to see the
family role as part of their social identity than men do (Gutek et al, 1991:561).
Studies have also indicated that the relationship between global work-family conflict
and job satisfaction is stronger for women than men (Bruck et al, 2002:336; Kosseck
and Ozeki, 1998:139). Therefore, the military work environment that reduces the
work-family conflict would attract more females than males.
6.1.3 Tenure
The number of years of military experience ranged from less than one year of service
to over fifteen years of service. The predominant groups of respondents were those
81
with 10-15 years of experience 36% and those with between 1-5 years of experience
34%. Seven percent of the respondents had less than 1 year of experience and this
most probably would be the health care interns. Only eight percent of the respondent
had more than 15 years of experience. This could be a reflection of the transformation
process, which is aimed at changing the demographics of the SANDF. The aim is to
ensure representivity at all levels of management (Ngqakayi, 2005, paragraph 5). As
a result middle and senior managers with long tenure, who formed part of the old
regime, were replaced by newly integrated members with fewer years of service. At
least fifty six percent of the respondents had had less than 10 years of experience.
This could also have been a reflection of the new appointments made after the
transformation process and as discussed earlier the new recruitment policy which
aims at maintaining a younger Defence Force.
6.1.4 Marital Status
The majority of the respondents were married 64% and 33% of the respondents were
single. There was a very small percentage of the sample 3% that were divorced. The
high percentage of married couples that the military medical services attract could be
as a result of the benefits that they receive. Firstly, the spouses and children of
married members are entitled to free medical aid. In addition, married members do
also qualify for the military housing and their children can study at state expense
through the military.
6.1.5 Children
Approximately seventy one percent of the respondents have children and the
remaining twenty nine percent of the respondents do not have children. The vast
majority of the health care professionals are married and are at the typical child
bearing age, therefore it can be expected that there will be more respondents with
children. The benefits for children, which include free medical aid and the
opportunity to study at state expense, would attract health care professionals with
children to the employ of the military health services.
82
6.2 MAJOR CONTRIBUTING FACTORS AFFECTING JOB
SATISFACTION
Based on the results in the previous chapter, the major contributing factors affecting
job satisfaction were identified as follows:
• Career Management
• Strategic Management and Support
• Nature of work itself
• Interpersonal Dynamics
Each of these components will be reviewed separately and the discussion will
highlight the items with majority endorsement (by 50% or more of the respondents) in
each component. This will include items that were positively endorsed, negatively
endorsed and "uncertain" responses endorsed by the majority of the respondents.
The current researcher is an employee at AMHU KZN, therefore the insights gained
from working for the organisation, will be discussed in an attempt to explain the
findings more meaningfully.
6.2.1 Career Management
Career management focuses on what the organisation can do to foster career
development. It is an ongoing process of preparing, implementing and monitoring
career plans undertaken by the individual alone or in concert with the organisation's
career systems (Desimone, Werner and Harris, 2002:458-459). It is important to
continually identify gaps between the organisation's strategy and the employee's
career concepts and motives, and then identify the optimal organisational structure
before deciding on the appropriate career management practices that need to be put in
place (Desimone etal, 2002:474).
A review of the career management component indicates that around a third 35% of
the items were positively endorsed by 50% or more of the respondents, a third 35%
83
a. Item 15
b. Item 18
c. Item 24
d. Item 31
e. Item 43
f. Item 52
g. Item 53
were negatively endorsed by majority of respondents and a third 30 % of the items
were endorsed neither negatively or positively by the majority of the respondents.
Negatively endorsed items: Seven items, 35% were negatively endorsed by 50% or
more of the respondents (items 15, 18, 24, 31, 43, 52, and 53).
These items include:
The staffing process is fair
I am satisfied with my salary
There are equal opportunities for everybody
I like the management style at my unit
I have control over my career in the military
An effort is put into career planning.
I receive career planning.
Dissatisfaction with salaries and career planning at the unit could be the result of the
disparities that exist between the health care professionals and military practitioners.
Military practitioners are military medical staff with no professional qualifications
that occupy the support structure posts in the medical unit. The military practitioners
get paid according to their military ranks and they appear to have excellent career
planning with regular promotions. Their salaries are not market related as most of
these individuals earn very high salaries in comparison to their post requirements.
However, health care professionals get paid according to their professional
qualifications, which is equivalent to what health care professionals at any
government organisation is paid.
It is often the case that military practitioners as subordinates earn more than their
health care professional managers. In essence it would appear that an individual with
no qualifications and experience, who joins the military as a military practitioner, has
better career prospects than the health care professional. This results in a feeling of
dissatisfaction among health care professionals. This would, therefore, be a very
important aspect that needs to be taken into consideration in the career management
of health care professionals.
84
The majority of the health care professionals do not believe that the staffing process is
fair. This could possibly be due to the lack of transparency and perceived fairness
with regard to the appointments made at unit level.
The restructuring of the SAMHS lead to the creation of a new hierarchy for area
military units, with the inclusion of an additional level of middle managers. These
posts could have provided promotional opportunities for health care professionals
with the necessary qualifications, ensuring their career development. However, there
was no skills audit done prior to the appointments and as a result many of these posts
were filled by personnel that were not perceived to meet the criteria of the posts.
These new managers were assigned to manage the services of health care
professionals however most of these individuals lacked the appropriate qualifications
and management skills. This resulted in high levels of dissatisfaction among health
care professionals, as they had to report to managers who did not have the necessary
knowledge pertaining to professional service delivery to make relevant decisions.
Many health care professionals were also experiencing a plateau in terms of their
careers and these posts would have provided excellent career development
opportunities, however these individuals were not considered for these posts.
There is also the perception that there are no equal opportunities for everyone. This
could actually be due to the transformation process in the South African National
Defence Force (SANDF), which resulted in the implementation of the affirmative
action policy where previously disadvantaged individuals were given preference in
terms of opportunities available. These opportunities included promotions and other
benefits such as the attendance of military courses, attendance of international
seminars and conferences, the appointment of military attaches, selections in terms of
special projects such as military liaison officer posts. According to Witt et al,
(2000:342), it is difficult for employees to react positively when they perceive that
promotions, pay raises and organisational rewards are based upon political
considerations, rather than formal objective considerations such as merit or output.
Issues such as affirmative action, equal employment opportunity and labour relations
affect the human resource function in an organisation and it is therefore important that
managers be aware of such issues when developing career management programs
(Desimone et al, 2002:500).
85
All these factors discussed relate to the perceived fairness in the organisation. This
perception of fairness in the organisation is known as organisational justice
(Greenberg and Baron, 2002:201). The equity theory of satisfaction is also based on
perceptions one has about fairness and unfairness (Chung 1977:117). It is therefore
important for the organisation to change peoples perceptions about the fairness of the
organisation as employees that feel that the organisation is treating them unfairly will
retaliate against the employers to ensure a more equitable outcome (Skarlicki and
Folger, 1997:442).
However it must be emphasised that the above comments are based on the current
researcher's own insights and experiences and should be verified in future research, as
they are only suggested reasons for the results.
Positively endorsed items: Seven items, 35% were positively endorsed by 50% or
more of the respondents (items 12,21, 23, 38,41,47 and 49).
These items include:
Most of the time my workload is manageable.
Promotions for professionals are few and far between
It is not clear which criteria are used to promote people
I am proud to work at AMHU KZN.
Not everyone has the same promotional opportunities.
The staffing process in this unit is unclear.
My future in this organisation is unclear.
Majority of the respondents do believe that the actual staffing process is clear, and
that there are clear criteria for promotions. However, as indicated in the previous
discussion irregularities seem to arise in the implementation of the staffing process at
unit level. As a result of these irregularities in the staffing process, a monotorium was
placed on staffing until proper control measures could be put in place.
In terms of promotions among health care professionals, there is consensus that all
professionals have the same promotional opportunities and that promotions are
received timeously. This could be because promotions of the health care
a. Item 12
b. Item 21
c. Item 23
d. Item 38
e. Item 41
f. Item 47
g- Item 49
86
professionals are based on functional promotions as set out in the public
administrative system and not according military rank promotions.
The South African Military Health Services (SAMHS) and subsequently AMHU
KZN, is being restructured to ensure a more efficient and cost effective service
delivery. There have been concerns raised mainly by the military practitioners as to
whether their posts will exist in the new structure. However, there is no danger of job
losses among health care professionals as they provide the essential medical services.
Therefore, most of the health care professionals are satisfied that their future in the
organisation is clear. According to Maslow's hierarchy of needs a secure working
environment with no threats of lay-off helps to satisfy an individuals safety needs
(Greenberg and Baron, 2003:193).
Most health care professionals are also satisfied that their workloads are manageable.
This according to Desimone et al, (2002:44) is very important as the way an
organisation chooses to design its jobs (in terms of the tasks one performs and the
scope of one's responsibilities) can affect an employee's satisfaction and productivity.
It is interesting to note that although health care workers are dissatisfied with
perceived inequalities in the organisation they are however proud to work at AMHU
KZN. This would indicate a high level of organisational commitment. According to
Blau (1986:578) organisational commitment is the degree to which an employee
identifies with a particular organisation and its goals and is keen on maintaining
membership in that organisation. In the military the majority of health care
professionals, join in uniform and therefore fulfill the requirements of being a soldier
first. They are bound to serve and honour their country and as officers of the state
they wear their ranks with pride and are proud to be a part of the military culture.
6.2.2 Strategic Management and Support
Strategic management involves a set of managerial decisions and actions that are
intended to maximise on the opportunities in the external environment and enhance
the long term performance of the organisation. Strategic management includes
strategy formulation, strategy implementation and control (Desimone et al, 2002:12-
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13). At formulation level, top management is required to assess the viability of the
current mission, objectives, strategies, policies, programs, technology, workforce and
other resources. Thereafter, they would need to assess threats and opportunities in the
external environment, and in light of these assessments, management can then
identify strategic factors that need to be changed or updated. It is important for
managers to ensure external alignment between the strategic plans of the organisation
and the external environment and internal alignment within the organisation
(Desimone et al, 2002:13). In terms of internal alignment the areas that would need
to be addressed include:
• Management practices - how employees are managed and treated.
• Organisational structure- how the organisation is structured.
• Human resource systems - how employees are selected, trained, compensated
and appraised and so on.
• Other work practices and systems - (e.g. the implementation of new
technology or information systems to improve work processes).
The value of this approach is that the organisation can be viewed as an entire system
where all parts of the organisation must work together as a whole to reach the goals of
the organisation. Some of the desired outcomes of such a work system are increased
productivity, quality, increased customer and employee satisfaction and quality of
work life (Desimone et al, 2002:13).
A review of the component on strategic management will indicate that around 15% of
the items were positively endorsed by 50% or more of the respondents and 23% of the
items were negatively endorsed by majority of respondents.
Negatively endorsed items: Three items, 23% were negatively endorsed by 50% or
more or the respondents (items 4, 9, and 17).
These items include:
a. Item 4: My organisation provides the resources and tools
that I need to do my job.
b. Item 9: My salary compares with the output I deliver.
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c. Item 17: My directorate is pro-active and can make things
happen.
The lack of resources and tools that are required to perform the job indicates that top
management has not adequately assessed the risks in the internal environment that
need to be addressed in order to maximise service delivery and meet the goals of the
organisation. This would probably explain why health care professionals do not
consider their Directorates as pro-active with the ability to handle issues that affect
service delivery. This implies that the Directorates are not continually scanning the
environment for potential threats or opportunities and identifying the strategic factors
that need to be changed or updated.
The compensation of health care professionals in relation their output is also an issue
in the internal environment that would need to be addressed. This affects the human
resource system, which is one of the subsystems of the organisation. It is important
for the Directorates to address the needs in this subsystem, as unmet needs in any
subsystem of the organisation would affect the ability of the organisation to meet its
strategic goals. The dissatisfaction of health care professionals with regards to their
salaries could be as a result of the perceived inequalities in pay in comparison with
military practitioners. According to Gruneberg (1979:20), an individual would
compare what they are receiving to what others are receiving and if they discover that
they receive less then this would lead to dissatisfaction. Greenberg and Baron
(2003:202-203) would view this as underpayment equity, which is a condition that
results in feelings of anger, in which the ratio of one's outcomes/inputs is less than the
corresponding ratio of another individual with whom that person compares himself or
herself. The individual that they compare themselves with could be anyone, like the
employees in their section, other employees in the organisation, individuals in the
same profession, or even themselves at an earlier period of employ.
Positively endorsed items: Two items, 15% were positively endorsed by 50% or
more of the respondents (items 5 and 28).
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These items include:
a. Item 5: I have confidence and respect for my directorate.
b. Item 28: My immediate supervisor is willing to listen and
assist when I have questions or problems.
Although health care professionals have indicated that they were not satisfied with
certain aspects of strategic direction and support by their Directorates as indicated in
the negatively endorsed items, they do however have respect and confidence for their
Directorates. Health care professionals expressed satisfaction with the management
practices within the unit, where their supervisors were willing to listen and assist in
resolving problems. Supervisors in this context refer to the health care professional
managers or staff officers that the respondents would report to in terms of their
professional functioning. There is a staff officer appointed in each medical profession.
Good management practices as discussed above, improves the internal alignment in
an organisation, which is one of the goals of strategic management.
6.2.3 Nature of Work Itself
A job has several distinguishing characteristics, including individual tasks or duties,
responsibilities, authority, relationships and skills requirements. These job
characteristics are related to job satisfaction. Since the nature of the work itself has an
effect on job satisfaction, it is important to ensure that the work is not repetitive and
unchallenging (Desimone et al, 2002:570). Often job enrichment is used as a
technique to improve the levels of job satisfaction among workers. Job enrichment
involves varying some aspect of the job in order to increase the potential to motivate
workers. In order to determine whether a job would need to be enriched, it is
important to determine the extent to which employees experience meaningfulness of
the work itself, responsibility of the work and its outcomes and knowledge of the
actual results of the work (Desimone et al, 2002:595).
A review of the component on the nature of the work itself indicates that (100%) of
the items were positively endorsed by 50% or more of the respondents.
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Positively endorsed items: Eight items, 100% were positively endorsed by 50% or
more of the respondents (items 32, 57, 58, 60, 61, 56, 64 and 67).
These items include:
a. Item 32
b. Item 56
c. Item 57
d. Item 58
e. Item 60
f. Item 61
g. Item 64
h. Item 67
I like the work I do
The impact of my work is clear
My work makes a difference in the DOD
I enjoy taking on new responsibilities in my work
I enjoy thinking of ways to improve the work I do
I get personal satisfaction from the job I do
My job is interesting to me
My job makes full use of my skills and abilities
It is quite clear from the above results that all the health care professionals do enjoy
the actual nature of their work. Most of the respondents do experience their work as
meaningful with 85% of the respondents, indicating that their work does actually
make a difference in the Department of Defence (DOD). In terms of responsibility of
the work, an overwhelming 85% of the respondents have also indicated that they do
enjoy taking on new responsibilities in their work and with regard to knowledge of the
actual results of the work, 80% of the respondents have indicated that the impact of
their work is clear.
According to Sanzotta (1977:25), professionals usually have a high need for
achievement. However, as Hellriegel and Slocum (1979:407) noted, achievement
satisfaction is not possible in an organisation where the tasks are routine and boring or
where there is no competition. Schermerhorn etal{\ 997:91) found that high
achievers prefer to work in organisations where there are individual responsibilities,
challenging goals and performance feedback.
The high levels of satisfaction with the all aspects of the nature of the work itself, is
probably an indication that the AMHU KZN does provide a stimulating and
interesting work environment and that health care professionals do experience job
fulfillment. The military is a unique environment, where the health care professional
has a dual role, to fulfill the requirements of being a soldier first and to render the
appropriate services as a health care practitioner. The health care professionals in the
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military receive wider exposure as they are trained in both a clinical and operational
field setting and they are expected to render services outside the borders of the
country during peacekeeping missions. The nature of the work is such that the health
care professionals in the military are faced with unique challenges that are
unparalleled to the civilian sector of society. Therefore, the work experience gained in
the military environment is highly interesting and stimulating in comparison to other
government institutions where the environment is more static and the work can be
described as more routine, repetitive and unchallenging.
6.2.4 Interpersonal Dynamics
According to Hertzberg's Two Factor Theory of job satisfaction, interpersonal
relations can be considered a hygiene factor or dissatisfier. Hygiene factors relate the
context of the job, that is it relates to the situation in which the person does what he or
she does. The hygiene factors are external to the employees and the job and are
considered extrinsic conditions of the job. This means that they are controlled by
someone other than the employees (Grobler et al, 2002:107-8). Hygiene factors such
as interpersonal relations when inadequate, leads to dissatisfaction but when adequate,
does lead to job satisfaction (Gruneberg, 1979:11-13). Interpersonal relations also
forms part of Alderfer's Need theory. The desire for satisfying interpersonal
relationships is related to Alderfer's Relatedness needs (Schermerhorn et al, 1997:90)
These relatedness needs correspond to Maslow's social needs which includes the need
for meaningful social relationships (Greenberg and Baron, 2003:194-5).
Interpersonal skill focuses on an individual's relationship with others, including
communication and teamwork (Desimone et al, 2002:321). There is a trend among
organisations to move toward team- based approaches to accomplishing work, which
usually involves team training with a strong interpersonal component (Desimone et al,
2002:342). Team building has been found to be the most effective intervention
technique for modifying satisfaction and other attitudes (Desimone et al, 2002:584).
A team-based approach to work is imperative in training soldiers in the military due
to the nature of the work and therefore forms part of all training programmes. With
regard to the provision of military medical services one of the strategic goals of the
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organisation is to ensure a multi-disciplinary approach (team based approach) in the
provision of health care.
Interpersonal skills are very important as graduates from high schools, colleges and
universities often lack the interpersonal skills that an organisation requires (Desimone
et al, 2002:342). In addition, more organisations are becoming multicultural and it is
important that people change some of the incorrect assumptions, values and beliefs
that they have about other cultures to ensure more effective cross cultural relations
(Desimone et al, 2002:342).
The fact that the AMHU KZN has a large proportion of young health care workers
would indicate that most of them are interns or newly appointed personnel. These
new graduates would require interpersonal skills training. In addition the
transformation process has resulted in a multi-cultural organisation. Although most
people experience difficulty in adapting to change, the military was very proactive
and had several programmes in place to facilitate the transformation process. This
helped to ensure better understanding and tolerance of other cultures in the
organisation and improve the interpersonal relations among employees.
According to David McClelland an important underlying need in understanding
human behaviour is the need for affiliation, which is the desire to establish warm,
friendly and interpersonal relations with others (Schermerhom et al, 1997:90). This is
in keeping with Maslow's need hierarchy where social needs refer to the need to be
affiliative, to have affective relationships with others such as friends and to be loved
and accepted by other people (Greenberg and Baron, 2003:193). The military medical
unit ensures that the need for affiliation is met by encouraging participation in social
events such as braais, parties, and other planned social events such as the health care
professional team building day, and officer's lunches. Regular sporting events are
often hosted such as the winter sports day and the summer sports day and this
includes all the health care professionals from the various military health service
centres throughout Kwa Zulu -Natal.
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A review of the component on interpersonal dynamics will indicate that around 25%
of the items were negatively endorsed by 50% or more of the respondents, and 75%
was neither negatively nor positively endorsed by majority of the respondents.
Negatively endorsed items: Two items, 25% were negatively endorsed by 50% or
more or the respondents (items 34 and 54).
These items include:
a. Item 34: The merit assessment process is fair
b. Item 54: The management of AMHU KZN is focused on the
needs of the individual.
From the discussion above it is apparent that the military unit made a positive
contribution to improving the interpersonal dynamics in the unit. However, the health
care professionals are dissatisfied with the merit assessment process and that
management is not focused on the needs of the individual. Both these issues have
managerial implications that can be explained by the expectancy theory.
Based on the expectancy theory managers should try to intervene actively in work
situations to maximise work expectancies, instrumentalities and valences that support
organisational objectives. To influence expectancies managers should recruit capable
individuals, train them well, provide them with the needed resources, and set clear
performance goals (Schermerhom etal, 1997:97).
To influence instrumentality managers should clarify performance-reward
relationships and ensure that individuals are actually rewarded for high performance,
so that the individual remains motivated (Schermerhom et al, 1997:97). Therefore, it
is important that the merit assessment process is fair and that individuals do qualify
for merit bonuses based on high performance. In AMHU KZN the policy stipulates
the percentage of employees that can receive merit bonuses based on race and military
ranks groups. However, this system may not be perceived as being fair as there can
be a higher percentage of high achievers coming from a specific race group or rank
group.
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To influence valences, managers should identify the needs that are important to each
individual with the emphasis on matching the needs of the employees with the
particular organisational reward (Schermerhorn et al, 1997:97). The health care
professionals at AMHU KZN are of the view that managers do not focus on the needs
of the individuals and it is these unmet needs that lead to dissatisfaction.
According to the expectancy theory people will be motivated to work when they
expect that they will be able to achieve the things that they want from their jobs
(Greenberg and Baron, 2003:207). Therefore, by managers improving their
interpersonal relations with the health care professionals they would be acutely aware
of the needs of the respondents and be able to meet the individual's expectations
about job related outcomes.
6.2.5 Summary
The item analysis suggests that the majority of the healthcare professionals at AMHU
KZN, are dissatisfied with structural issues (such as resources, staffing, career
planning, salaries and administration) and are satisfied with the nature of the work
itself, despite this they do believe that their future in the unit is clear and they are
proud to work at AMHU KZN.
6.3 THE LEVEL OF JOB SATISFACTION ACROSS THE DIFFERENT
DEMOGRAHIC VARIABLES
The workforce in the military health services has become increasingly more diverse
since the transformation of the (SANDF) and it can be expected that this trend will
continue. Demographic characteristics are background variables (e.g. age, gender)
that help shape what a person becomes over time and it is considered to be the heart
and soul of workplace diversity (Schermerhorn et al, 45). It is therefore important to
understand that diversity exists in workforces and manage it accordingly to prevent a
workforce that has problems working cooperatively, is unhappy, disillusioned and
underutilised (Moorhead and Griffin, 1995:520).
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The discussion below will examine if there are differences in job satisfaction across
the different demographic variables in AMHU KZN.
6.3.1 Gender
Findings on the impact of gender on job satisfaction are inconsistent. While some of
the findings suggest that there are no differences in the level of job satisfaction among
men and women (Mannheim, 1993:138), others do suggest that expectations of
working - women in terms of job satisfaction are different from those of men (Martin
and Hanson, 1985:91).
The findings in AMHU KZN suggest that there are no differences in the level of job
satisfaction among men and women.
There could be several explanations in support of the results. A study by
Varca et al (1983:348) examined job satisfaction among alumni 5 years after they
graduated from college. Results indicated that at higher occupational levels men
expressed more satisfaction than women in terms of pay and opportunities for
advancement. Hagedorn (1996:569) has also presented evidence that the job
satisfaction of female academics is lower when their earnings fall below the earning
of comparable males. However, these factors that lead to dissatisfaction would not
relate to the health care professionals in the SAMHS due to the implementation of the
policy on gender equity. This policy ensures that women have equal opportunities
and receive the same benefits as their male counterparts. This could therefore be one
of the reasons that females experience similar levels of satisfaction to males.
The greater educational attainment of women has also resulted in increased number of
women in managerial and professional positions. However, corresponding social
roles and responsibilities have not kept pace. The women still assume the primary
responsibility of child and home care (Aryee, 1993:823). According to the gender
role theory, women are more likely to see the family role as part of their social
identity than men do (Gutek, et al 1991:561). A study on work-family conflict and
job satisfaction has also found that when work is seen as interfering with the time and
energy needed at home, working parents especially working mothers become
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dissatisfied with their jobs (Grandey, et al 2005:306). Consistent with the gender role
theory, several studies have supported the proposition that the relationship between
global work-family conflict and job satisfaction is stronger for women than for men
(Brack, et al 2002:336-352; Kossek and Ozeki, 1998:139-149).
As mentioned in previous discussions, the military aims to foster a supportive
environment with the focus on health military families which forms part of the
military culture. This family orientated approach reduces the work family conflict
and, therefore, women are able to enjoy similar levels of job satisfaction compared to
men. In terms of the support provided to families the military ensures that there are
psychologists and social workers available to assist individuals deal with any personal
or family related issues. The chaplain and the social worker of the unit will also
provide a support network to an individual's family when the individual is away from
home, either on course or on detached operational duty. The management of the unit
is accommodating of the needs of a working mother ensuring that they are given time
to handle the responsibility of child and homecare. The unit also has planned social
events for the family like family days, childrens programmes, and a host of other
events that incorporates the family into the military culture.
6.3.2 Age
The findings in AMHU KZN suggest that there are no differences in job satisfaction
across the different age categories. This is not in keeping with studies that have found
differences in job satisfaction across the different age groups (Weaver, 1980:364-367,
Mottaz, 1987:387). There could be several explanations as to why there are no
differences noted in terms of job satisfaction across the different age categories.
Typically the effect age on job satisfaction is often explained by reviewing the stages
of career development. Greenhaus, Callanan, Godshalk, 2000 cited in Desimone et al
(2002:466), has indicated a five stage model of career development. Stage one is the
preparation for work (Age 0-25). Stage two is the oganisational entry stage (Age 18-
25), where an individual selects a job and an organisation in which to begin
employment. Stage three is the early career stage (Age 25-40) during this stage the
individual becomes established in a career and in an organisation. Stage four is the
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midcareer stage (Age 40-55) at this stage career plateauing and obsolescence of one's
skill are usually experienced. The final stage, stage five is the late career stage (Age
55 - retirement) this is where the individual strives to remain productive and maintain
a sense of self esteem. Individuals also face the challenge of disengaging from wotk
and retiring.
Although this traditional model of career development does fit many organisations,
they may not adequately explain job satisfaction across the age categories in the
military. Greenhaus et al 2000 cited in Desinmone et al 2002:470 point out that the
above stages of career development cannot simply be used to classify individuals into
a particular stage but to "understand" how careers unfold and how people relate at
different stages of their careers and lives.
According to Desimone et al 2002:470, it is also important to note that in
organisations that face technological change, competition, political pressure, and non
traditional employment arrangements and lack of stability in terms of employment
security, the traditional model of career development does not fit as well.
The military environment is very different to most civilian organisations in that it
does not offer a traditional career path to individuals. Due to the nature of the work
the military has to ensure that it maintains a young, fit combat ready force. The
appointments in the military are not dictated by one's profession alone but on age and
fitness criteria. In addition, due to the fact that there no permanent appointments, but
only short to medium term appointments most individuals cannot settle into a long
term career path in the military. These individuals do not enjoy the same career
security as individuals that have permanent appointments and therefore the typical
career developmental stage described above may not apply to these individuals.
The transformation process also resulted in the integration of individuals of different
age categories into the military. The traditional model of career development may not
apply to these individuals as all these individuals irrespective of their age are trying to
adapt to a completely unique culture and environment. As mentioned previously the
health care professionals have a dual role of being both a soldier and a health care
professional. Therefore their careers will not be comparable to their colleagues in the
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civilian sector and the way their career unfolds and the way that these individuals
relate to it may differ irrespective of age.
6.3.3 Tenure
Tenure appears to be a more consistent and stable predictor of job satisfaction than
chronological age (Bedeian, et al 1992:36). However the findings in AMHU KZN
suggest that tenure has no impact on the levels of job satisfaction.
According to Farkas and Tetrick (1989:855-860), there is a positive relationship
between tenure, the length of time spent in the organisation, and job satisfaction. The
longer the time spent in the organisation, the more satisfied managers are with their
jobs. This may indicate that once the process of acculturation is over, managers settle
into their jobs, have increased organisational commitment and seem to like their jobs
The transformation process in the military, which resulted in integration of previously
disadvantaged individuals, together with the restructuring of the military medical
services, has meant that health care professionals had to learn to adapt to a
multicultural environment with the implementation of new structures, systems and
working procedures. The drastic change to the existing organisational environment
would have meant that health care professionals would have had to undergo the
process of accultauration again. Health care professionals with many years of service
would not be able to settle into their jobs as would have to adapt to a new transformed
organisation. Therefore contrary to research, this study indicated that job satisfaction
does not differ with tenure.
6.3.4 Marital Status
Research indicates that married individuals tend to have fewer absences, lower
turnover rates and greater job satisfaction than do unmarried individuals
(Schermerhorn et al, 1997:45).
The findings at AMHU KZN indicate that there are no differences in the level of job
satisfaction among married and unmarried individuals.
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Most of the factors related to job satisfaction in this study do not differ amongst
married and unmarried individuals. Both groups receive the same benefits, such as
free medical aid and a housing subsidy. They also have the same degree of job
security and both groups express high levels of satisfaction with regard to the nature
of their jobs.
One of the main factors that could lead to greater dissatisfaction among married
individuals in the military environment would be the fact that they are
separated from the families for extended periods of time during deployment and this
would have a negative impact their family life.
However, the results are not suggestive of this and this could be attributed to the
supportive environment that the military provides to the family members of deployed
health care professionals. The fact that individuals are reassured that the needs of
their families are addressed during their absence could possibly improve their levels
of satisfaction.
6.3.5 Children
A positive relationship has been found between the number of children and job
satisfaction (Schermerhom et al, 1997:45). Studies have also shown that military
personnel that are married and have dependant children are less likely to leave the
military (Kilburn et al, 2001 cited in Antecol et al, paragraph 37).
The findings at Area Military Health Unit Kwa-Zulu Natal indicate that there are no
differences in the level of job satisfaction among individuals with or without children.
The reasons that could account for this would be similar to the reasons cited for the
demographic variable, marital status as most of the married individuals have children.
The issue of deployment would once again be one of the main factors that could affect
the satisfaction levels of individuals that do have children in comparison to those that
do not have children. The fact that individuals will be separated from their children
for extended periods of time would as mentioned previously have a negative impact
on family life and lead to greater levels of dissatisfaction. However, this would be
100
balanced off, by the fact that the unit provides excellent support structures to the
family of deployed individuals. Other benefits include the fact that the children are
entitled to free medical aid and studies at state expense.
6.3.6 Summary
The results of this study indicate that there were no differences in job satisfaction
across the demographic variables of namely, age, gender, tenure, children and marital
status. Although no qualitative data was obtained to explain these findings, in the
opinion of the researcher the following issues could offer a possible explanation for
the results on job satisfaction across the demographic variables:
• The integration and transformation process affected the demographic profile
of the organisation, therefore it is difficult to make comparisons and
deductions based on the typical career development cycle.
• The SAMHS is a unique organisation, which is well differentiated from other
healthcare organisations especially in terms of its employment arrangements.
Therefore the typical trends observed across the demographic variables among
health care professionals in other organisations may not be applicable to the
military organisation. The force structure, the nature of work itself, benefits
for married members and those with children, social support structures and
recruitment policies are but some of the factors that need to be taken into
consideration when attempting to interpret the results.
6.4 CORRERLATION BETWEEN JOB SATISFACTION AND
PROPENSITY TO LEAVE
Considerable research has been done on voluntary turnover with intent to quit as a
commonly proposed antecedent. Conclusions from traditional turnover research show
that intention to quit work (turnover intention) is the best predictor of actual voluntary
turnover in an organisation (Steensma et al, 2004:215).
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This study examined the relationship between job satisfaction and propensity to leave
and found that a strong correlation existed between total job satisfaction and
propensity to leave.
This finding is consistent with research done on job satisfaction and propensity to
leave. Most conceptual models of voluntary turnover assume that job dissatisfaction is
the main cause of labour turnover, and there are considerable findings of the negative
relationship between employee turnover and job satisfaction (Brayfield and Crockett,
1955: 396 and Locke 1975: 457-480).
This study also further examined the relationship between the four different
components that were identified as the major contributing factors affecting job
satisfaction and propensity to leave. This included:
• Career management and propensity to leave
• Strategic management and support and propensity to leave
• The nature of the work itself and propensity to leave
• Interpersonal dynamics and propensity to leave
6.4.1 Career Management and Propensity to Leave
There was a strong correlation between career management and propensity to leave.
The lack of career planning was one of the main issues highlighted by respondents in
this study. Career planning a very important aspect of career management and this
includes activities that help the individual to develop and carry out career plans
(Desimone et al, 2002:458). Successful career planning would ensure that an
individual will know what they want in terms of their career and what steps to take to
achieve this goal (Desimone et al, 2002:458). Therefore, individuals who do not
receive career planning will not know what to expect in terms of their careers, which
could result in increased levels of dissatisfaction.
The dissatisfaction with the staffing process could be due to the fact that there was no
skills audit done when matching people to posts and therefore the staffing process was
102
not perceived to be fair. According to the human capital theory individuals decide
whether to stay with a firm, in part on the basis of whether their jobs provide the best
fit with and returns on their qualifications. Individuals acquiring new qualifications
should be staffed in promotional posts as this would make use of their capabilities.
Promotions assist in re-establishing a match between employee skills and job
requirements, and they should reduce the attractiveness of other jobs opportunities,
independently of wages (Liu, 1984:1137). Porter and Steers (1973:151-176) found
that the lack of perceived equitability in the promotion procedures lead to high levels
of dissatisfaction among professionals and this resulted in increased turnover.
Dissatisfaction with one's salary could result in increased propensity to leave the
organisation. Porter and Steers (1973:151-176) found that pay could be a major cause
of turnover. The problem was not just a result of the actual level of pay but also the
perceived equitable level of pay. Turnover studies also confirm that the perceived
equitable level of pay in relation to others in the company was a major factor affecting
voluntary quits (Van Yperen et al, 1996:429). This is especially important when
considering health care professionals, who are considered to be high achievers.
According to McCelland's theory of need motivation, high achievers are often good at
what they do and would not remain long in a job that does not pay them equitably for
performing well (Hellriegel and Slocum, 1979:407). In AMHU KZN health care
professionals compare their salaries with the military practitioners and other health
care professions. Often when salaries are not considered to be equitable health care
professionals opt to quit their professional careers and take on appointments as
military practitioners as this affords them an opportunity to earn higher salaries. In
this way even though health care professionals may not be leaving the organisation
itself, there is still a loss of professional staff.
The political transformation of the SANDF and the implementation of the affirmative
- action policy, resulted in the perception of a lack of equal opportunities for
everyone. According to research, organisational politics can predict intention to leave
an organisation. Organisational politics is perceived as a negative force contributing
to negative affective and behavioural outcomes (Ferris and Kacmar, 1992:94). To
explain it more simply, it is difficult for employees to react positively when they
perceive that promotions, pay raises and organisational rewards (among other things)
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are based upon political considerations, rather than formal, objective considerations,
such as merit or output (Witt et al, 2000:342).
The management style at the unit was also cited as another reason for increased levels
of dissatisfaction. The health care professionals have a dual role in the military, first
as a soldier and secondly as a professional. It is difficult to always merge professional
ethics with military ethics which results in inter-role conflict. The middle managers
are mainly military practitioners with no professional qualifications and no medical
background and as a result they tend to adopt a military style of management. The
goals of the organisation often differ from the goals of the profession which results in
interrole conflict. Interrole conflict arises from incompatible role requirement
between two or more work related roles and it has been found to generate negative
consequences, such as lower levels of job satisfaction as well as higher propensity to
leave the organisation (Liu et al, 2001:470).
Research in the United States military indicates that career related discrimination,
results in increased intentions to leave the military (Antecol and Cobb-Clark,
paragraph 19). Therefore, it is important to identify and understand all the factors
related to career management and address these needs so that individuals would be
more inclined to remain in AMHU KZN.
6.4.2 Strategic Management and Support and Propensity to Leave
In terms of strategic management and support it would be important for managers to
ensure external alignment between the strategic plans of the organisation and the
external environment and internal alignment within the organisation as this would
enhance the long term performance of the organisation (Desimone et al, 2002:13).
The main issues related to dissatisfaction concerned the internal alignment within the
unit. The issues of concern were the lack of resources, lack of equitable remuneration
and lack of support form the Directorate. These issues relate to organisational support
in the unit. Research has shown that organisational support can predict intention to
leave the organisation (Ferris et al, 1992:94).). Organisational support is regarded as
a global construct intended to measure perceptions of support provided by the
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organisation, and these perceptions have been found to be positively related to
positive work outcomes (Rhoades and Eisenberger, 2002:698). Employees who
perceive high levels of organisational support tend to increase work effort, citizenship
behaviours, and tenure (Cropanzano et al, 1997:159).
An examination of tenure in environments with low organisational support indicate
that individuals with low tenure are more prone to leaving the organisation. The
negative effect of these environments suggests that the benefits accrued are not
commensurate with the personal investment made. This is deemed an inequitable
situation by the individual prompting them to leave the organisation (Valle et al,
2004:118).
6.4.3 Nature of the Work Itself and Propensity to Leave
There was a strong correlation between the nature of the work itself and propensity to
leave. According to Hertzberg's two factor theory of job satisfaction, the inherent
nature of the work itself can be referred to as a motivator or satisfier (Gawel, 1997,
paragraph 6). Motivators are considered to be intrinsic in nature and they reflect the
content of the job and higher level needs (Grobler et al, 2002: 107-8). Motivators are
factors which if present in the working situation, lead to satisfaction, but if absent
does not lead to dissatisfaction.
The majority of the respondents expressed overwhelming satisfaction with the nature
of their work itself, and this could be an indication that the health care professionals
are content with their professional career choices. This is an important deduction as
research has indicated that often individuals that have no clear idea of where their
vocational interests lie may be more likely to quit their jobs than individuals with
clear ideas (Porter and Steers, 1973:151-176).
The respondents in the study also indicated that the nature of the work does have a
positive impact on them, and that they do find their work interesting and they do get
personal satisfaction from their work. This indicates very positive job related
attitudes toward their work.
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Job related attitudes such as job involvement also affect turnover. Job involvement is
the degree to which a person identifies psychologically with his or her job and
considers his or her perceived performance level important to self worth. High levels
of job involvement have been associated with lower turnover rates (Blau and Boal,
1987: 290).
6.4.4 Interpersonal Dynamics and Propensity to Leave
There was a strong correlation between interpersonal dynamics and propensity to
leave.
According to Antecol and Cobb-Clark (paragraph 3), racial and ethnic diversity
affects job satisfaction. The transformation of the SAMHS has resulted in AMHU
KZN becoming even more racially and ethnically diverse. Research has shown that in
the United States military, these diversity issues have resulted in increased reports of
racial and ethnic harassment.
Racial harassment has been found to significantly increase job dissatiafction
irrespective of the type of harassment considered. Furthermore threatening racial
incidents have also resulted in increased intentions to leave the military (Antecol and
Cobb-Clark, paragraph 19).
Another factor that affects interpersonal dynamics is group demography. Group
demography also helps in predicting turnover. Groups and organisations are made up
of cohorts, which are defined as individuals who hold a common attribute. For
instance, everybody bom in 1960 is of the same age. Several studies have found
turnover to be higher among individuals that fall outside a cohort. Group demography
therefore suggests that such attributes as age or the date that someone joins an
organisation would enable one to predict turnover (Robbins, 1996:315-316; McCain
etal, 1983:626-641).
The transformation of the SAMHS led to the disintegration of cohorts formed in the
old SADF. Many of the members of the former SADF had taken early retirement
packages and those that remained in the military found it difficult to merge with the
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newly integrated members. Many of these individuals over time could not adapt to
the new organisation and also chose to leave the SANDF.
6.4.5 Summary
From the above discussion it is clear that high the levels of dissatisfaction among
health care professionals, results in increased propensity to leave the organisation.
There was also a strong correlation between career management, strategic
management and support, nature of the work itself, interpersonal dynamics and
propensity to leave. Therefore, it is important to ensure that the necessary steps are
taken to improve job satisfaction among health care professionals so that the
necessary force structure can be maintained according to the needed mix of
experience, grade and skill.
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CHAPTER SEVEN
CONCLUSIONS
7.1 INTRODUCTION
The dawn of a free, democratic South Africa resulted in the subsequent
transformation of the SANDF. The SAMHS as one of the four arms of service was
also part of the transformation process, which included the implementation of the
affirmative action and equal opportunities policy. The SAMHS had to also transform
in terms of service delivery with the goal of improving the quality and efficiency of
the military health services and provide access to excellent medical services to all
SANDF members, their families and approved clientele. The reason for this is that
healthcare is a crucial part of the non-pay benefits package and a key element of the
military quality of life.
The transformation process, followed by the restructuring of the SAMHS and the call
for improved service delivery placed increased demands on health care professionals
to ensure the provision of an optimal health care for the clientele. However, as
indicated in the literature review, there is a direct correlation between customer
satisfaction and employee satisfaction. Therefore, in order to improve client
satisfaction it was important to firstly to address issues affecting job satisfaction
among the health care professionals. A study was therefore carried out on a sample of
health care professional in AMHU KZN with the aim of exploring three objectives,
namely, to determine the major contributing factors affecting job satisfaction among
health care professionals; to determine if there were differences in job satisfaction
across the different demographic variables; and to determine if there was a correlation
between job satisfaction and propensity to leave.
7.2 DEMOGRPAHIC PROFILE OF THE HEALTHCARE
PROFESSIONALS
The sample consisted of 61 health care*professionals in AMHUKZN, the majority of
whom were female (64%). Studies have indicated that the relationship between
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global work-family conflict and job satisfaction is stronger for women than men
(Bruck et a!, 2002:336; Kosseck and Ozeki, 1998:139). Therefore, the military work
environment that reduces the work-family conflict would attract more females than
males.
However the recent changes in the work environment with increased external
deployment of healthcare professionals, outside the borders of the country, could have
an adverse effect on females joining or remaining in the military.
The British Military also recognises that it has problems recruiting and retraining
personnel and have found that separation from family and friends is an important
factor preventing people from wanting to join the military (Limbert, 2004:38).
As discussed previously another reason for the military attracting a higher percentage
of women, could have been due to the fact that certain healthcare professions are still
female dominated, like nursing.
The age ranged between 20 to 59 years old with the majority of respondents (64%)
being under 40 years old. One of the strategic goals of the DOD's Human Resource
Strategy for 2010 is to rejuvenate the SANDF's human resource composition with
young, fit and healthy members (DOD, 2003, paragraph 48). This remains one of the
most important criteria for military personnel to deploy outside the borders of the
country. This would explain why the majority of respondents are below the age of 40
years old. An aging workforce would increase personnel expenditure, as they would
not be able to deploy externally. Therefore another strategic goal of the SANDF is to
introduce a new service system that will reduce personnel expenditure and optimise
force level flexibility (DOD, 2003, paragraph 48).
Approximately 56% of the respondents had less than 10 years of military experience,
which is in keeping with the new recruiting policy that aims at providing just short
and medium term service. This is in keeping with the military's intention of
maintaining a young, fit, combat ready force.
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Most of the respondents 64% were married and 71% of the respondents had children.
This high percentage of married individuals with children could as mentioned earlier
be the result of benefits like free medical aid for spouses and children, children being
able to study through the military, the reduced work-family conflict in the military
environment and the military accommodation available to married individuals.
However, here again the recent introduction of external deployments might result in
fewer married individuals with children joining the SANDF.
7.3 MAIN FACTORS AFFECTING JOB SATISFACTION
In response to the main factors affecting job satisfaction, the following areas are of
importance:
7.3.1 Career Management
The main issues included firstly career guidance and planning which most health care
professionals felt were poorly managed. Secondly, most respondents do not feel that
there is equal opportunity for everyone and they also do not believe that the staffing
process is fair. The factors mentioned above could be interrelated. As mentioned
earlier the SANDF is in the process of transformation. The aim of the transformation
of the Department of Defence (DOD) is to achieve the goal of a non-racial, non-sexist
and non-discriminatory institution whose composition shall broadly reflect the
demographics of the country (DOD, 2003, paragraph v). According to Witt et al,
(2000:342), it is difficult for employees to react positively when they perceive that
promotions, pay raises and organisational rewards are based upon political
considerations, rather than formal objective considerations such as merit or output.
Issues such as affirmative action, equal employment opportunity and labour relations
affect the human resource function in an organisation and it is therefore important that
managers be aware of such issues when developing career management programs
(Desimone et al, 2002:500).
The transformation process has lead to the implementation of various policies such as
the affirmative action policy, and the policy on gender. Staffing is based on
individuals meeting the criteria of these policies, which often gives opportunities to
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previously disadvantaged individuals. Therefore, employees may be under the
impression that there are no equal opportunities for everyone and the staffing process
may not be perceived as being fair. Most appointments are made at headquarters
level, where individuals are earmarked for posts and this may explain why individuals
feel that they have no control over their careers in the military. In addition managers
themselves are adjusting to the transformation process and the effect it has on the
organisation. This may explain why they do not provide adequate career planning and
guidance to the healthcare professionals.
Remuneration was also one of the frustrations of the respondents. However,
dissatisfaction with remuneration is a perennial problem and may well not be able to
be resolved at unit level. One of the contributing factors to dissatisfaction expressed
with salaries could be the fact that military practitioners with no tertiary qualifications
earn better salaries than the healthcare professionals. According to Gruneberg
(1979:20), an individual would compare what they are receiving to what others are
receiving and if they discover that they receive less then this would lead to
dissatisfaction. Greenberg and Baron (2003:202-203) would view this as
underpayment equity, which is a condition that results in feelings of anger, in which
the ratio of one's outcomes/inputs is less than the corresponding ratio of another
individual with whom that person compares himself or herself. The individual that
they compare themselves with could be anyone, like the employees in their section,
other employees in the organisation, individuals in the same profession, or even
themselves at an earlier period of employ.
Lastly, the restructuring has also lead to the appointment of a whole new level of
middle managers, who lack the appropriate management skills. This could explain
the obvious unhappiness expressed by health care professionals with regard to the
management style at the unit.
7.3.2 Strategic Management and Support
Salaries were once again highlighted as an important area of concern among
respondents. Respondents did not feel that their salaries compared with the output
that they delivered. It is important to note that healthcare professionals have a dual
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role, they firstly need to fulfill the requirements of being a soldier in uniform and
secondly they are also responsible to render the relevant professional healthcare
service.
The effect of extrinsic rewards such as money on high achievers is complex. High
achievers do have a high opinion of the value of their services and, therefore, prefer to
receive the pay of a valued employee. Money is a strong symbol of their achievement
and adequacy, and may lead to feelings of dissatisfaction if they feel they their
remuneration is low in comparison to others (Hellriegel and Slocum, 1979:407).
The healthcare professionals also indicated that their directorates are not pro-active.
This could be related to the fact that the directorates are responsible for determining
the salary grading of the healthcare professionals. Although some directorates have
upgraded the salaries of their respective professional grouping, other directorates have
failed to re-grade the salaries. The lack of the necessary resources and tools required
to do the job was also an issue of concern. This could be another area where the
Directorates need to ensure that they are proactive and ensure internal alignment
within the organisation, by ensuring that the necessary resources are available for
efficient service delivery.
The healthcare professionals expressed satisfaction with their professional managers,
indicating that they were willing to listen and assist with questions and problems that
they had experienced.
7.3.3 The Nature of the Work Itself
The majority of the respondents have indicated that they do enjoy the actual nature of
their work. The respondents have indicated that they do enjoy taking on new
responsibilities in their work, that their work is meaningful and interesting to them
and that the impact of their work is clear. This could be attributed to the fact that the
military provides a stimulating and interesting work environment where health care
professionals can experience job fulfilment. The healthcare professionals working in
the military environment receive a wider exposure compared to other government
organisations, as they also receive military training to be able to render services in a
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combat situation. Achievement satisfaction is not possible in an organisation where
the tasks are routine, boring or where there is no competition (Hellriegel and Slocum,
1979:407). A high need achiever prefers to work in organisations where there are
individual responsibilities, challenging goals and performance feedback
(Schermerhorn et al, 1997:91).
Satisfaction with the nature of the work itself could also be a reflection of the high
level of satisfaction of health care professionals with their career choices. Often
individual's who have no clear idea of where their vocational interests lie may be
more likely to quit their jobs than individual's with clear ideas. (Porter and Steers,
1973:151-176).
7.3.4 Interpersonal Dynamics
Maintaining good interpersonal dynamics is very important in the military considering
the nature of the work. One of the strategic goals of the organisation is to ensure a
multi-disciplinary team approach in the provision of health care and this is practiced
by health care professionals in AMHU KZN. According to McClelland's need
motivation theory, professionals have the need for affiliation that is the desire to
establish warm, friendly interpersonal relations with others (Schermerhorn et al,
1997:90).
In addition, a lot of emphasis is placed on planned social events, which is meant to
improve interpersonal relations. The officer commanding of the unit has various
combined social events planned for members from all the health service centres.
Social needs can be met in organisations by encouraging participation in social
events, such as office braais or parties. An organisations sports club is also a good
opportunity for meeting social needs, by giving employees a chance to socialise and
develop friendships (Greenberg & Baron, 2003:193).
The main issue of concern highlighted by respondents related to management.
Respondents felt that the merit assessment process needed be administered fairly by
managers. Based on the expectancy theory managers can influence instrumentality by
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clarifying the performance-reward relationships and ensure that individuals are
actually rewarded for high performance, so that the individual remains motivated
(Schermerhorn etal, 1997:97).
The healthcare professionals were also of the opinion that managers should be
focused on the needs of individuals. Again based on the expectancy theory in order to
influence valences, managers should identify the needs that are important to each
individual with the emphasis on matching the needs of the employees with the
particular organisational reward (Schermerhorn etal, 1997:97).
7.4 LEVEL OF JOB SATISFACTION ACROSS THE DIFFERENT
DEMOGRAPHIC VARIABLES.
The second objective of the study was to determine if there were differences in job
satisfaction across the various demographic variables. There were no differences
noted in the level of job satisfaction across the demographic variables of gender,
tenure, marital status, age and whether or not respondents had children. The fact that
the military culture does assist in reducing the work -family conflict could explain
why there is no difference in the level of job satisfaction between males and females.
In addition the women enjoy equal opportunities and receive the same benefits as
their male counterparts and this could be another reason why women experience
similar levels of satisfaction to men.
The transformation process and the restructuring of the military medical services
resulted in drastic changes to the existing organisational environment. Therefore,
health care professionals would have had to undergo the process of acculturation
again. Health care professionals with many years of service would not be able to
settle into their jobs as would have to adapt to a new transformed organisation. This
study indicated that job satisfaction does not differ with tenure.
There was no difference in job satisfaction between the different age categories. This
could also be in part attributed to the transformation and restructuring process which
meant that irrespective of age all the employees would be have to adapt to the changes
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in the work environment. It should also be noted that the majority of the respondents
were below the age of 40, in a similar age cohort, therefore it would be less likely to
observe distinct differences. The new recruitment policy also aims at maintaining a
younger defence force therefore comparisons across the different age groups would
not be appropriate.
The benefits received by married members and those with children could also account
for the high levels of satisfaction, which is comparable to single members and those
without children.
7.5 CORRELATION BETWEEN JOB SATISFACTION AND
PROPENSITY TO LEAVE
The final objective of the study was to determine if there was a correlation between
job satisfaction and propensity to leave. There was a strong correlation between total
job satisfaction and propensity to leave. There was also a strong correlation between
the four components of job satisfaction namely, career management, strategic
management, the nature of the work itself, interpersonal relations and propensity to
leave.
Successful career planning would ensure that an individual will know what they want
in terms of their career and what steps to take to achieve this goal (Desimone et al,
2002:458). Therefore, individuals who do not receive career planning will not know
what to expect in terms of their careers, which could result in increased levels of
dissatisfaction.
It is also important to ensure the career progression of healthcare professionals into
promotional posts. However the staffing process was not perceived to be fair which
lead to increased levels of dissatisfaction. Promotions assist in re-establishing a
match between employee skills and job requirements, and they should reduce the
attractiveness of other jobs opportunities, independently of wages (Liu, 1984:1137).
Porter and Steers (1973:151-176) found that the lack of perceived equitability in the
promotion procedures lead to high levels of dissatisfaction among professionals and
this resulted in increased turnover.
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The health care professionals have a dual role in the military, first as a soldier and
secondly as a professional. It is difficult to always merge professional ethics with
military ethics which results in inter-role conflict. Inter-role conflict arises from
incompatible role requirement between two or more work related roles and it has been
found to generate negative consequences, such as lower levels of job satisfaction as
well as higher propensity to leave the organisation (Liu et al, 2001:470).
In terms of strategic management and support the issues of concern were the lack, of
resources, lack of equitable remuneration, and the lack of support from the
Directorate, all of which relate to organisational support. Research has shown that
organisational support can predict intention to leave the organisation (Ferris et al,
1992:94). An examination of tenure in environments with low organisational support,
indicate that individuals with low tenure are more prone to leaving the organisation.
The negative effect of these environments suggests that the benefits accrued are not
commensurate with the personal investment made. This is deemed an inequitable
situation by the individual prompting them to leave the organisation (Valle et al,
2004:118).
The majority of the respondents expressed overwhelming satisfaction with all aspects
of the nature of the work itself. This implies that healthcare professionals get
personal satisfaction from their work, which indicates positive job related attitudes
toward their work. Job related attitudes such as job involvement also affect turnover.
Job involvement is the degree to which a person identifies psychologically with his or
her job and considers his or her perceived performance level important to self worth.
High levels of job involvement have been associated with lower turnover rates (Blau
and Boal, 1987:290).
There was a strong correlation between interpersonal dynamics and propensity to
leave. Although the military strives to maintain strong interpersonal relations the
transformation and restructuring of the SAMHS has lead to the disintegration of old
cohorts formed in the SADF and has created new challenges with the integration of all
the previous political forces into the new SANDF.
116
These findings are significant as once the transformation process and the restructuring
of military medical service is complete, the focus would shift to the task of stabilising
the force. A high turnover of health care professionals will cause turbulence and
affect the delivery of health services, even if measures are in place to manage this.
Therefore, it is important to reduce the propensity to leave by including visible and
challenging career opportunities, the satisfaction of reasonable expectations for the
future, the availability of a military career for those who perform well, appropriate
remuneration, family support and managerial and strategic support and direction.
The goal of AMHU KZN would be to attract, develop and retain a high quality group
of health care professionals with the appropriate distribution of skills, and also ensure
the balance of age and experiences that supports the attainment of mission readiness
whilst providing a high standard of health care. To accomplish this goal the
organisation would have to ensure they do promote and maintain high levels of job
satisfaction among these individuals.
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CHAPTER EIGHT
RECOMMENDATIONS
8.0 RECOMMENDATIONS
In light of the conclusions of this study the following recommendations can be made:
a. Respondents expressed a high degree of satisfaction with the various aspects
of the nature of work itself. Respondents were willing to extend themselves in their
work, perceive their work to be personally satisfying and meaningful and perceive
their work to add value to the organisation. Therefore it is important that this finding
be capitalised on, by finding ways to create work that is stimulating, rewarding and
enriching as this would be one of the greatest assets of AMHU KZN. According to
McClelland's need theory achievement satisfaction is not possible in an organisation
where the tasks are routine, boring or where there is no competition (Hellriegel and
Slocum, 1979:407). A high need achiever prefers to work in organisations where
there are individual responsibilities, challenging goals and performance feedback
(Schermerhorn et al, 1997:91). According to the Hertzberg approach the only way to
motivate employees is to upgrade their jobs. Hertzberg has shown strong support for
job enrichment, as a means of tapping the motivational potential within every worker
(Sanzotta, 1977:27).
It would be important to look at job rotation between the different health service
centres to afford individuals the opportunity to be exposed to working in different
environments with different challenges. Job rotation is a good way of introducing
variety into an employee's career, especially if the employee is bored with the current
work. Job rotation was also related to outcomes such as promotion opportunities,
satisfaction, improved knowledge and skills. However it is important to ensure that
job assignments used in job rotation offer developmental opportunities, rather than
just the chance to do something different (Desimone et al, 2002:487-488).
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There should also be more flexible work schedules and processes which would allow
individuals to be more creative in their approach to work and also improve their levels
of job satisfaction. Although there is a policy that allows individuals to work
flextime, the managers at AMHUKZN are often reluctant to implement the policy.
This often results in dissatisfaction among healthcare professionals due to the
autocratic style of management.
The flextime schedule allows employees latitude in determining their starting and
ending times in a given workday. Flextime schedules were found to be positively
related to job satisfaction and satisfaction with supervisor (Desimone etal, 2002:586).
b. Compensation is an important factor in determining how to employ the
military human resource management system strategically. It is important for the
SAMHS to develop a compensation system that will attract, retain and motivate a
diverse work force. This is especially important in light of the recent introduction of
external deployments outside the borders of the country. This poses new challenges
such as the increased risk of danger to health care professionals and negative social
consequences, such as longer periods of separation from family.
The separation from friends and family is an important factor preventing people from
joining the military. In addition the major cause of stress during peace-keeping
deployments is boredom. This is because the pace of peacekeeping missions is slower
than that of war, and the aims may be less clear-cut and meaningful (Limbert,
2004:38-39). Therefore, the length of the deployment period should also be carefully
considered as long periods of external deployment could have an adverse affect on the
predominantly female population of healthcare workers in AMHU KZN.
It is important when designing the components of a future compensation system that
all these factors are assessed and their implications for SAMHS are determined, as it
is imperative that a combat ready force is maintained. Although members do receive
a danger allowance the introduction of a separate professional allowance for health
care professionals should be investigated as an added incentive to remain in the
military.
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c. There must be transparency in staffing and promotions. Staffing and
promotions should be done in line with the career management and development of
individuals. Healthcare professionals that have reached a plateau in their career
should be given preference in terms of common posts in AMHU KZN structure.
As individuals acquire new qualifications they may outgrow their current jobs,
making other options more attractive. A promotion means that their existing firm has
recognised their new qualification and has found them new responsibilities that are a
closer match to their capabilities. Promotions assist in re-establishing a match
between employee skills and job requirements, and they should reduce the
attractiveness of other jobs opportunities, independently of wages (Liu, 1984:1137).
Other studies have also confirmed that organisations investing in employees'
marketable skills can reduce turnover if individuals acquiring the skills are
subsequently promoted (Benson, Finegold, Mohrman, 2004:315).
Therefore, is necessary that a skills audit be completed prior to staffing to ensure the
appointment of the right person for the post. The posts should be advertised internally
to ensure that all the applicants that meet the criteria are given an opportunity to apply
for the post. There should be a career management committee at unit level that can
assess all applications and make the necessary recommendations for the filling of the
post. All recommendations made at unit level should be screened at the higher
headquarters to ensure that the individual recommended does meet the necessary
criteria of the post and is the best candidate for the post.
d. It is important to ensure the career planning and development of health care
professionals. Healthcare professionals who have the necessary medical background,
experience and the appropriate managerial qualifications should be considered for key
middle management promotional posts in lieu of military practitioners. It is also
important to emphasise job enrichment and lateral movement for individuals who
have reached a career plateau. The career planning managers should also form part of
the career management committee that can make necessary recommendations with
regards to career development of the individuals at unit level. Recommendations
should be made in line with the human resourced strategies of the organisation. This
120
would ensure that career planning does not just become an annual paper exercise. It is
also important to integrate the individuals developmental planning with the
organisational strategic planning. Career managers at unit level should also liaise
with the directorates of the different professional groupings so that there is regular
assessment and feedback of the career development plans of the health care
professionals at the unit level.
e. Salaries of health care professionals should be equitable in comparison to
other health care professionals and military practitioners. According to Gruneberg
(1979:20), an individual would compare what they are receiving to what others are
receiving and if they discover that they receive less then this would lead to
dissatisfaction. Directorates need to examine the hierarchy of each unit. Health care
professionals with a tertiary qualification as mangers should not be earning lower
salaries, in comparison to military practitioners with no qualifications, as
subordinates. Salaries should not just be equitable compared to other healthcare
practitioners in other government organisations, but it should also be equitable in
terms of the salaries of military practitioners in the same organisation.
Directorates need to understand that skills retention is critical in the military taking
into consideration the high costs of military training that employees' undergo.
According to McCelland's theory of need motivation, high achievers are often good at
what they do and would not remain long in a job that does not pay them equitably for
performing well (Hellriegel and Slocum, 1979:407). Although some Directorates
have been pro-active and have re-graded salaries of their professional grouping others
have not. Porter and Steers (1973:151-176) found that pay could be a major cause of
turnover. The problem was not just a result of the actual level of pay but also the
perceived equitable level of pay. Turnover studies also confirm that the perceived
equitable level of pay in relation to others in the company was a major factor affecting
voluntary quits (Van Yperen et al, 1996:429).
It should therefore be priority that posts are re-graded and that salaries are improved
to reduce the ease of movement of health care professionals to other organisations.
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f. It is difficult to always merge professional ethics with military ethics which
results in inter-role conflict. The middle managers are mainly military practitioners
with no professional qualifications and no medical background and as a result they
tend to adopt a military style of management. The goals of the organisation often
differ from the goals of the profession which results in interrole conflict. Interrole
conflict arises from incompatible role requirement between two or more work related
roles and it has been found to generate negative consequences, such as lower levels of
job satisfaction as well as higher propensity to leave the organisation (Liu et at,
2001:470).
It is therefore important that managers do not adopt the typical military command and
control style of management of health care professionals. This is often resisted by the
health care professionals who prefer a more participatory style of management.
Managers need to be focused on the needs of the individual and need to diversity
training to manage the challenges of a newly integrated, transformed military health
service. It is therefore, of benefit to the organisation that common posts in the
structure be filled with healthcare professionals who have a medical background and
are better able to understand and relate to the needs of the other healthcare
professionals.
g. The management of AMHU KZN should also conduct regular job satisfaction
surveys that would assist in identifying issues that affect the job satisfaction levels of
health care professionals at each health care facility in AMHU KZN and ensure the
necessary action is taken to improve the levels of job satisfaction.
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CHAPTER NINE
LIMITATIONS OF THE STUDY AND DIRECTIONS
FOR FUTURE RESEARCH
9.1 LIMITATIONS OF THE STUDY
The findings and recommendations of this study need to be considered within the
context of the following limitations:
• It is restricted to one geographical area and as such it cannot be assumed to
apply to health care professionals based at medical care facilities in other
provinces.
• KwaZulu- Natal does not have a military hospital and therefore results from
this study cannot be extrapolated to provinces that do have a military hospital.
• Health care Professionals could not be differentiated according to their
professional groupings because the small sample sizes would have breached
confidentiality.
• The SAMHS ethics committee did not allow comparison across the different
Health Service Centres, due to the small sample size and the possible breach
of confidentiality.
• The questionnaire was not designed to include qualitative data. Interpretations
of quantitative findings were therefore based on current researcher's own
experiences, which is not ideal.
• The questionnaires were administered by the officers in charge at the
Ladysmith and Matubatuba Health service centers. Although participants
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placed their returns in sealed unmarked envelopes they could have still had
concerns with regard to a possible breach in confidentiality and anonymity.
• Due to restrictions by Ethics Committee certain demographic data that would
have been relevant could not be included like the ranks of members,
professional groupings, and previous force that the member belonged to before
transformation.
• The exact age and tenure of the respondents could not be obtained as this
would have breached confidentiality. The Ethics committee only allowed this
information to be captured in categories.
• Ideally a sample size of at least a 100 people should have been used in this
study to ensure statistically significant results when using the principal
component method for statistical analysis.
• The job satisfaction survey was an exceptionally long survey and respondents
may not have given careful thought to responses toward the latter part of the
questionnaire.
• A lot of surveys are conducted at the AMHU KZN, and often members do not
get feedback on the results of the surveys and they find that recommendations
made are often not implemented. Therefore the completion of surveys may
appear a futile exercise to respondents. This may affect their commitment to
answering the survey questionnaires accurately.
However despite these limitations the current study has considerable value because it
does highlight the main factors affecting job satisfaction, which will enable the
organisation to address these specific issues and improve levels of job satisfaction.
The improved levels of job satisfaction would also impact positively on intentions to
leave and thereby ensure force stability and combat readiness, which is critical to the
functioning of SAMHS.
124
9.2 DIRECTIONS FOR FUTURE RESEARCH
Some topics for future research include the following:
a. Since only the KwaZulu-Natal province was covered in this study, it is
recommended that the SAMHS conduct further studies to incorporate all provinces as
to determine the overall level of job satisfaction among health care professionals in
the SAMHS.
b. It would also be interesting to do a comparative study of job satisfaction
among the health care professionals at all of the military medical tertiary institutions
(military hospitals) and the area military healtihi units (sickbay structures) in the
SAMHS.
c. Job satisfaction levels should be determined for each professional category
throughout the SAMHS as this would highlight specific issues that should be
addressed by each Directorate to improve the levels of job satisfaction.
d. It would also be interesting to determine the effect of external deployments
outside the borders of the country on the levels of job satisfaction between male and
female health care professionals in the SAMHS.
e. It is important to determine the main factors affecting job satisfaction levels of
health care professionals when compared to military practitioners.
125
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136
APPENDIX A
SURVEY ON JOB SATISFACTION AMONG HEALTH CARE PROFESSIONALS AT AMHUKZN
INFORMED CONSENT FORM
Good Day. My name is Major Veni Maharaj. I am a dietician at AMHU KZN.
I am currently completing my Masters Degree in Business Administration and an integral part
of this degree is the completion of a research report.
I am interested in looking at employee satisfaction among health care professionals in AMHU KZN as part of my research. The aim of this study is to determine the level of employee satisfaction and identify the key factors that contribute to employee satisfaction, so as to assist the organization in addressing these issues and create a work environment that contributes to excellence in health care.
I will be administering questionnaires to all health care professionals in AMHU KZN. Your participation in this study will take approximately 20 minutes. In order for my research to be of any use I ask for complete honesty. There are no right or wrong answers. If you are unsure of how to answer a question, answer it in terms of your understanding of the question and choose the answer, which is most applicable to you.
Your participation is anonymous and confidential. Please remember that your participation is voluntary and that no negative consequences shall befall either participation or non -participation. You are free to withdraw from this study at any stage for any reason. Completion of the questionnaire will be accepted as informed consent.
When you have completed the questionnaire please hand it back to me.
Should you require further information please contact:
Major V Maharaj (031) 3691148. (Researcher)
DrKOrtlepp (033) 2606168. (Supervisor)
137
JOB SATISFACTION QUESTIONNAIRE: HEALTH CARE
PROFESSIONALS AT AMHU KZN
The purpose of this questionnaire is to get an understanding of the satisfaction,
needs, requirements and expectations of the health care professionals at AMHU
KZN.
SECTION A: DEMOGRAPHIC DATA
• Please fill in the following information. • Place a cross where appropriate.
1. Gender Male Female
2. Age 20-29 40-49
30-39 50-59
3. How long have you been a member of the SANDF?
Less than a year 10-15 years
1-5 years 15 +years
6-10 years
4. Marital Status Married Single Divorced Cohabitating
5. Do you have Children?
Yes No
138
SECTION B PLEASE FOLLOW THE DIRECTIONS BELOW IN ANSWERING THIS QUESTIONNAIRE
• Please answer the statements honestly and openly. There are no right and wrong answers. • Please indicate your response by placing an X in the block depending how you feel. E.g
strongly agree. • Please respond to all statements.
Strongly Disagree
Dis-agree Uncertain Agree Strongly Agree
4 My organization provides the resources and tools that I need to do my job.
5 I have confidence and respect for my Directorate.
6 There is too much red tape in resolving the resource problems.
7 The benefits package we receive is as good as most other organizations.
8 It is difficult to render a professional service in my present "physical surrounding".
9 My salary compares with the output I deliver.
10 My Directorate promotes my profession. 11 I cannot deliver an excellent service
because of the unavailability of needed resources.
12 Most of the time my workload is manageable.
13 It is unclear what the vision is for my profession into the DOD as a whole.
14 My Directorate supports me when others challenge my work.
15 The staffing process in unit is fair 16 There is opportunity for my growth and
development in this unit. 17 My Directorate is proactive and can
make things happen. 18 I am satisfied with my salary. 19 The "physical surroundings" create a
negative image of AMHU KZN. 20 There is group cohesion among all health
care professionals in AMHU KZN. 21 Promotions for professionals are few and
far between. 22 There is co-operation among the various
departments in each Health center 23 It is not clear which criteria are used to
promote people. 24 There are equal opportunities for every
one. 25 The management of AMHU KZN is too
focused on administrative processes. 26 The administrative process for salary
adjustments is very slow. 27 I experience the "physical surroundings"
as unpleasant.
139
Strongly Disagree
Disagree Uncertain Agree Strongly Agree
28 My immediate supervisor is willing to listen and assist when I have questions and problems.
29 I receive recognition for a job well done from my seniors.
30 There are clear policies set by my Directorate
31 I like the management style at my unit
32 I like the work I do. 33 The management of AMHU KZN is
too focused on military rules. 34 The merit assessment process is fair. 35 My level of morale is high.. 36 I am treated as a professional. 37 The management of AMHU KZN
administers policies fairly. 38 I am proud to work at AMH KZN. 39 There is co-operation among the
various health care professions across the different health service centres in AMHU KZN.
40 I am looking for another job. 41 Not everyone has the same
promotional opportunities. 42 There is group cohesion in our health
service centre. 43 I have control over my career in the
military. 44 Planned social events improve
cohesion among health care professionals.
45 There are clear guidelines set by my Directorate.
46 My seniors motivate me in my work. 47 The staffing process in this unit is
unclear. 48 I have job security. 49 My future in this organization is
unclear. 50 Opportunities are not provided for
my professional development 51 Racial issues are prominent within
the unit. 52 An effort is put into career planning 53 I receive career guidance. 54 The management of AMHU KZN is
focused on the needs of the individual.
55 I am conscientious about doing my job well.
140
Strongly Disagree
Disagree Uncertain Agree Strongly agree
56 I get personal satisfaction from the job I do.
57 The impact of my work is clear. 58 My work makes a difference in the
DOD. 59 My Directorate fights for the
interest of my profession. 60 I enjoy taking on new
responsibilities in my work. 61 I enjoy thinking of ways to
improve the work I do. 62 I feel personally rewarded from the
job I do. 63 There is communication among the
various health care professions across the different health service centres in AMHU KZN.
64 My job is interesting to me. 65 I plan to be part of the long -term
future of this unit. 66 The management of AMHU KZN
administers rules and discipline consistently
67 My job makes full use of my skills and abilities.
141
JOB SATISFACTION QUESTIONNAIRE:
PROFESSIONALS AT AMHU KZN
HEALTH CARE
SECTION C
• Please place an X where necessary. • Please respond to all statements
1. If you were completely free to choose, would you prefer to continue working
in your present job or not?
Not at all likely Somewhat likely Quite likely Extremely likely
2. If you were completely free to choose, how likely is it that you will actively
look for a job next year?
Not at all likely | Somewhat likely [ ] Quite likely ] | Extremely likely
3. I often think about leaving this organization.
Strongly DisAgree Disagree Slightly Disagree Neither Agree nor Disagree Slightly Agree Agree Strongly Agree
I will probably look for a job next year.
Strongly DisAgree Disagree Slightly Disagree Neither Agree nor Disagree Slightly Agree Agree Strongly Agree
THANKYOU FOR YOUR PARTICIPATION.
142
APPENDIX B
ORIGINAL JOB SATISFACTION QUESTIONNAIRE (MPI)
Strongly Disagree
Disagree Uncertain Agree Strongly Agree
7. My organisation provides the resources and tools 1 need to do my job.
0 0 0 0 0
8. 1 cannot deliver an excellent service because of the unavailability of needed resources.
0 0 0 0 0
9. Enough is being done to resolve resource problems. 0 0 0 0 0
10. I experience the'physical surroundings" as unpleasant. 0 0 0 0 0
11. The "physical surroundings" have an effect on my work satisfaction.
0 0 0 0 0
12. The "physical surroundings" create a negative image of MPI. 0 0 0 0 0
13. My Directorate cares about the future of the Unit 0 0 0 0 0
14. My Directorate promotes my profession. 0 0 0 0 0
15. My Directorate fights for the interest of my profession. 0 0 0 0 0
16. I t is unclear how my profession fits into the DoD as a whole. 0 0 0 0 0
17. I t is unclear what the vision is for my profession within the DoD.
0 0 0 0 0
18. My Directorate supports me when others challenge my work. 0 0 0 0 0
19. There are clear guidelines set by my Directorate. 0 0 0 0 0
20. There is clear policies set by my Directorate. 0 0 0 0 0
21. I am satisfied with my salary. 0 0 0 0 0 22. My salary compares with the
outputs that I deliver. 0 0 0 0 0
23. Promotions are done promptly. 0 0 0 0 0 24. Prerequisites for promotions are
constantly changing. 0 0 0 0 0 25. Promotions are made possible
for a certain group of people and not for others.
0 0 0 0 0
26. I t is not clear which criteria are used to promote people. 0 0 0 0 0
27. There are no equal opportunities for every one. 0 0 0 0 0
28. The merit assessment process is fair. 0 0 0 0 0
29. The administrative process for salary adjustments is very slow. 0 0 0 0 0
143
Strongly Disagree
Disagree Uncertain Agree Strongly Agree
30. I have control over my career in the military. 0 0 0 0 0
31. I get positive feedback about my work from my peers. 0 0 0 0 0
32. I get positive feedback about my work from my seniors. 0 0 0 0 0
33. My peers motivate me in my work. 0 0 0 0 0
34. My seniors motivate me in my work. 0 0 0 0 0
35. 1 like the management style within my wing. 0 0 0 0 0
36. The management of MPI is focused on the needs of members of MPI.
0 0 0 0 0
37. The management of MPI is too focused on military rules. 0 0 0 0 0
38. The management of MPI is too focused on administrative processes.
0 0 0 0 0
39. My personal preferences are taken into consideration in the allocation of projects.
0 0 0 0 0
40. I am treated as a professional. 0 0 0 0 0 41. Deadlines set for projects are
unrealistic. 0 0 0 0 0
42. I am proud to work at MPI. 0 0 0 0 0 43. There is cooperation between
the various wings in MPI. 0 0 0 0 0 44. There is communication
between the various wings in MPI.
0 0 0 0 0
45. There is cooperation amongst the various departments in my wing.
0 0 0 0 0
46. There is group cohesion in our wing. 0 0 0 0 0
47. There is group cohesion amongst all members of MPI. 0 0 0 0 0
48. Unit outings are a waste of time. 0 0 0 0 0 49. The staffing process is fair. 0 0 0 0 0 50. There are staffing problems. 0 0 0 0 0 51. The staffing procedures in this
organisation are confusing. 0 0 0 0 0
52. 1 have job security. 0 0 0 0 0 53. My future in this organization is
unclear. 0 0 0 0 0 54. Opportunities are not provided
for my professional development.
0 0 0 0 0
55. Racial issues are prominent within the Unit 0 0 0 0 0
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Strongly Disagree
Disagree Uncertain Agree Strongly Agree
56. An effort is put into career planning. 0 0 0 0 0
57. I receive career counseling. 0 0 0 0 0 58. 1 like the work 1 do. 0 0 0 0 0 59. 1 am conscientious about doing
my job well. 0 0 0 0 0 60. The work 1 do is important to me
personally. 0 0 0 0 0
61. The impact of my work is clear. 0 0 0 0 0 62. My work makes a difference in
tiieDoD. 0 0 0 0 0 63. My job is just a way to make a
living. 0 0 0 0 0 64. 1 enjoy taking on new
responsibilities in my work. 0 0 0 0 0 65. 1 enjoy thinking of ways to
improve the work 1 do. 0 0 0 0 0 66. 1 get personal rewards from the
work 1 do. 0 0 0 0 0 67. 1 am looking for another job. 0 0 0 0 0 68. My job is interesting to me. 0 0 0 L 0 0 69. 1 feel demoralised. 0 0 0 0 0 70. MPI has a bright future 0 0 0 0 0 71. I plan to be part of the long-term
future of this Unit. 0 0 0 0 0
APPENDIX C ITEM FREQUENCIES: JOB SATISFACTION QUESTIONNAIRE
Item Number & Text Strongly Disagree
Disagree Uncertain Agree Strongly Agree
Count (%) Count (%) Count (%) Count (%) Count (%) 1 My organization provides the resources and tools
that I need to do my job. 12 19.7 21 34.4 2 3.3 23 37.7 3 4.9
2 I have confidence and respect for my Directorate. 6 9.8 11 18 10 16.4 25 41 9 14.8 3 There is too much red tape in resolving the
resource problems. 22 36.1 23 37.7 8 13.1 5 8.2 3 4.9
4 The benefits package we receive is as good as most other organizations.
9 14.8 13 21.3 10 16.4 26 42.6 3 4.9
5 It is difficult to render a professional service in my present "physical surrounding".
5 8.2 17 27.9 2 3.3 30 49.2 6 9.8
6 My salary compares with the output I deliver. 15 24.6 27 44.3 7 11.5 11 18 1 1.6 7 My Directorate promotes my profession. 13 21.3 17 27.9 11 18 18 29.5 2 3.3 8 I cannot dehver an excellent service because of the
unavailability of needed resources. 9 14.8 30 49.2 3 4.9 14 23 5 8.2
9 Most of the time my workload is manageable. 6 9.8 8 13.1 5 8.2 36 59 6 9.8 10 It is unclear what the vision is for my profession
into the DOD as a whole. 5 8.2 16 26.2 15 24.6 18 29.5 6 9.8
11 My Directorate supports me when others challenge my work.
9 14.8 15 24.4 15 24.6 20 32.8 2 3.3
12 The staffing process is fair. 18 29.5 20 32.8 10 16.4 12 19.7 1 1.6 13 There is opportunity for my growth and
development in this unit. 15 24.6 18 29.5 14 23 11 18 3 4.9
14 My Directorate is proactive and can make things happen.
11 18 25 41 9 14.8 14 23 2 3.3
15 I am satisfied with my salary. 26 42.6 20 32.8 6 9.8 9 14.8 -16 The "physical surroundings" create a negative
image of AMHUKZN. 10 16.4 13 21.3 6 9.8 23 37.7 9 14.8
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Item Number & Text Strongly Disagree
Disagree Uncertain Agree Strongly Agree
Count (%) Count (%) Count (%) Count (%) Count (%) 17 There is group cohesion among all health care
professionals in AMHU KZN. 9 14.8 19 31.3 17 27.9 11 18 3 4.9
18 Promotions for professionals are few and far between.
18 29.5 28 45.9 7 11.5 4 6.6 3 4.9
19 There is co-operation among the various departments in each Health center
7 11.5 14 23 9 14.8 28 45.9 3 4.9
20 It is not clear which criteria are used to promote people.
19 31.1 28 45.9 6 9.8 6 9.8 2 3.3
21 There are equal opportunities for every one. 24 39.3 25 41 8 13.1 3 4.9 1 1.6 22 The management of AMHU KZN is too focused
on administrative processes. 7 11.5 28 45.9 12 19.7 7 11.5 5 8.2
23 The administrative process for salary adjustments is very slow.
28 45.9 26 42.6 5 8.2 2 3.3 —
24 I experience the "physical surroundings" as unpleasant.
9 14.8 18 29.5 4 6.6 24 39.3 5 8.2
25 My immediate supervisor is willing to listen and assist when I have questions and problems.
6 9.8 10 16.4 3 4.9 26 42.6 16 26.2
26 I receive recognition for a job well done from my seniors.
11 18 13 21.3 9 14.8 24 39.3 4 6.6
27 There are clear policies set by my Directorate 6 9.8 18 29.5 8 13.1 26 42.6 3 4.9 28 I like the management style at my unit. 11 18 20 32.8 13 21.3 13 21.3 4 6.6 29 I like the work I do. 4 6.6 2 3.3 2 3.3 31 50.8 22 36.1 30 The management of AMHU KZN is too focused
on military rules. 10 16.4 19 31.1 9 14.8 14 23 9 14.8
31 The merit assessment process is fair. 14 23 17 27.9 16 26.2 11 18 3 4.9 32 My level of morale is high.. 12 19.7 15 24.6 12 19.7 17 27.9 4 6.6 33 I am treated as a professional. 14 23 14 23 4 6.6 26 42.6 3 4.9 34 The management of AMHU KZN administers
policies fairly. 10 16.4 17 27.9 19 31.1 13 21.3 1 1.6
35 I am proud to work at AMH KZN. 7 11.5 7 11.5 14 23 26 42.6 6 9.8
147
Item Number & Text Strongly Disagree
Disagree Uncertain Agree Strongly Agree
Count (%) Count (%) Count (%) Count (%) Count (%) 36 There is co-operation among the various health
care professions across the different health service centres in AMHU KZN.
5 8.2 12 19.7 16 26.2 23 37.7 4 6.6
37 I am looking for another job. 12 19.7 14 23 14 23 15 24.6 6 9.8 38 Not everyone has the same promotional
opportunities. 22 36.1 25 41 8 13.1 3 4.9 3 4.9
39 There is group cohesion in our health service centre.
7 11.5 11 18 22 36.1 17 27.9 3 4.9
40 I have control over my career in the military. 15 24.6 18 29.5 12 19.7 15 24.6 1 1.6 41 Planned social events improve cohesion among
health care professionals. 2 3.3 10 16.4 10 16.4 28 45.9 11 18
42 There are clear guidelines set by my Directorate. 2 3.3 17 27.9 15 24.6 22 36.1 4 6.6 43 My seniors motivate me in my work. 8 13.1 18 29.5 10 16.4 19 31.1 5 8.2 44 The staffing process in this unit is unclear. 6 9.8 36 59 11 18 7 11.5 1 1.6 45 I have job security. 6 9.8 11 18 19 31.1 20 32.8 4 6.6 46 My future in this organization is unclear. 13 21.3 19 31.1 18 29.5 7 11.5 4 6.6 47 Opportunities are not provided for my professional
development. 15 24.6 12 19.7 15 24.6 14 23 5 8.2
48 Racial issues are prominent within the unit. 15 24.6 25 41 10 16.4 10 16.4 1 1.6 49 An effort is put into career planning. 14 23 21 34.4 14 23 11 18 1 1.6 50 I receive career guidance. 17 27.9 22 36.1 10 16.4 12 19.7 — 51 The management of AMHU KZN is focused on
the needs of the individual. 13 21.3 23 37.7 19 31.1 6 9.8 —
52 I am conscientious about doing my job well. 1 1.6 3 4.9 2 3.3 25 41 30 49.2 53 The impact of my work is clear. 1 1.6 7 11.5 4 6.6 28 45.9 21 34.4 54 My work makes a difference in the DOD. 1 1.6 2 3.3 6 9.8 30 49.2 22 36.1
148
Item Number & Text Strongly Disagree
Disagree Uncertain Agree Strongly Agree
Count (%) Count (%) Count (%) Count (%) Count (%) 55 My Directorate fights for the interest of my
profession. 12 19.7 10 16.4 20 32.8 12 19.7 6 9.8
56 I enjoy taking on new responsibilities in my work. 2 3.3 4 6.6 3 4.9 32 52.5 20 32.8 57 I enjoy thinking of ways to improve the work I do. _. 3 4.9 3 4.9 34 55.7 21 34.4 58 There is communication among the various health
care professions across the different health service centres in AMHU KZN.
10 16.4 18 29.5 12 19.7 20 32.8 1 1.6
59 My job is interesting to me. 2 3.3 5 8.2 3 4.9 32 52.5 19 31.1 60 I plan to be part of the long -term future of this
unit. 6 9.8 3 4.9 20 32.8 21 34.4 9 14.8
61 The management of AMHU KZN administers rules and discipline consistently
8 13.1 15 24.6 13 21.3 22 36.1 3 4.9
62 My job makes full use of my skills and abilities. 4 6.6 16 26.2 5 8.2 26 42.6 10 16.4 63 I get personal satisfaction from the work I do 3 4.9 8 13.1 6 9.8 24 39.3 16 26.2
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APPENDIX D
RESEARCH OFFICE (GOVAN MBEKI CENTRE) WESTV1LLE CAMPUS TELEPHONE NO.: 031 - 2603587 EMAIL: [email protected]
7APRiL2006
MRS. V GOVENDER (902301840) GRDUATE SCHOOL OF BUSINESS
Dear Mrs. Govender
ETHICAL CLEARANCE APPROVAL NUMBER : HSS/06129A _
I wish to confirm that ethical clearance has been granted for the following project:
"Employee satisfaction among Health Care Professionals in Area Military Health Unit KZN (AMHU KZN)"
Yours faithfully
MS. PHUMELELE XIMBA RESEARCH OFFICE
PS: The following general condition is applicable to all projects that have been granted ethical clearance:1,
THE RELEVANT AUTHORITIES SHOULD BE CONTACTED IN ORDER TO OBTAIN THE NECESSARY APPROVAL SHOULD THE RESEARCH INVOLVE UTILIZATION OF SPACE AND/OR FACILITIES AT OTHER INSTITUTIONS/ORGANISATIONS. WHERE QUESTIONNAIRES ARE USED IN THE PROJECT, THE RESEARCHER SHOULD ENSURE THAT THE QUESTIONNAIRE INCLUDES A SECTION AT THE END WHICH SHOULD BE COMPLETED BY THE PARTICIPANT (PRIOR TO THE COMPLETION OF THE QUESTIONNAIRE) INDICATING THAT HBSHE WAS. INFORMED OF THE NATURE AND PURPOSE OF THE PROJECT AND THAT THE INFORMATION GIVEN WILL BE KEPT CONFIDENTIAL.
cc. '* Faculty Officer —£cc. Supervisor (Dr. K Ortlepp)
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